Pediatric Endocrinology Unit, Hospital d'Enfant Abderrahim Harouchi Chu Ibn Rochd, Casablanca, Morocco.
Laboratory of Clinical Immunology, Allergy, and Inflammation LICIA, Faculty of Medicine and Pharmacy Hassan II University-Casablanca, Morocco.
Afr Health Sci. 2020 Sep;20(3):1337-1343. doi: 10.4314/ahs.v20i3.40.
Type I diabetes (T1D) is an autoimmune disease with a prediabetic, asymptomatic period characterized by the selective destruction of insulin-producing β cells. During the pre-clinical phase, various auto-antibodies are generated against several beta cell antigens such as anti glutamate acid decarboxylase (Anti-GAD), anti tyrosine phosphatase (Anti-IA2). Today, the coupled detection of Anti-IA2 with that of Anti-GAD proves its great importance in the diagnosis and prediction of type 1 diabetes. The combined positivity for both antibodies has a specificity and a positive predictive value of 100%.
In this work, we evaluate the diagnostic value of anti-GAD and anti-IA2 antibodies in a series based on 78 Moroccan subjects initially under 16, suspected T1D.
Our series consists mainly of 74% of newly diagnosed patients for T1D and 26% of confirmed diagnostic patients, of whom 52% are females. The mean age of diagnosis is 7 ± 4 years, the mean of HbA1c at the time of diagnosis is 11.63 ± 2.16%, and the percentage of family history in our series is 69%. The proportion of positive results for anti-IA2 antibodies and anti-GAD antibodies are, respectively, 76.92% and 62.82%, and 52.56% of patients are positive for both auto-antibodies. This study confirms that anti-GAD and anti-IA2 auto-antibodies assays can detect patients early and the autoantibodies can persist several years after diagnosis of type 1 diabetes.
This study confirmed the diagnosis and classification of T1D (type 1A) in 87.18% of patients, and we reported that the prevalence of anti-GAD and anti-IA2 is higher in girls than in boys.
1 型糖尿病（T1D）是一种自身免疫性疾病，有一个糖尿病前期、无症状的阶段，其特征是胰岛素产生β细胞的选择性破坏。在临床前阶段，会针对多种β细胞抗原产生各种自身抗体，如谷氨酸脱羧酶抗体（Anti-GAD）、酪氨酸磷酸酶抗体（Anti-IA2）等。如今，Anti-IA2 与 Anti-GAD 的联合检测在 1 型糖尿病的诊断和预测中具有重要意义。两种抗体的联合阳性具有 100%的特异性和阳性预测值。
在这项工作中，我们评估了抗 GAD 和抗 IA2 抗体在 78 名最初年龄在 16 岁以下的摩洛哥疑似 1 型糖尿病患者系列中的诊断价值。
我们的系列主要由 74%的新诊断为 1 型糖尿病患者和 26%的确诊诊断患者组成，其中 52%为女性。诊断时的平均年龄为 7 ± 4 岁，诊断时的平均 HbA1c 为 11.63 ± 2.16%，我们系列中的家族史比例为 69%。抗 IA2 抗体和抗 GAD 抗体的阳性结果比例分别为 76.92%和 62.82%，52.56%的患者两种自身抗体均为阳性。本研究证实，抗 GAD 和抗 IA2 自身抗体检测可早期检测到患者，且自身抗体在 1 型糖尿病诊断后可持续数年。
本研究证实了 87.18%患者的 T1D（1 型 A）诊断和分类，我们报告说，女孩中抗 GAD 和抗 IA2 的患病率高于男孩。
