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自身免疫性甲状腺疾病与锌转运体8自身抗体相关的胰岛自身免疫有关。

Autoimmune thyroid disease correlates to islet autoimmunity on zinc transporter 8 autoantibody.

作者信息

Cai Yun, Yan Jieni, Gu Yong, Chen Heng, Chen Yang, Xu Xinyu, Zhang Mei, Yu Liping, Zheng Xuqin, Yang Tao

机构信息

Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA.

出版信息

Endocr Connect. 2021 May 19;10(5):534-542. doi: 10.1530/EC-20-0650.

Abstract

OBJECTIVE

The most common coexisting organ-specific autoimmune disease in patients with type 1 diabetes mellitus (T1DM) is autoimmune thyroid disease (AITD). However, there have been few clinical reports based on a large population about the prevalence of zinc transporter 8 autoantibody (ZnT8A) and other islet autoantibodies in AITD patients. We aimed to explore the presence of islet autoantibodies, ZnT8A, glutamic acid decarboxylase autoantibodies (GADA) and insulinoma-associated antigen 2 autoantibodies (IA-2A) compared with thyroid autoantibodies, thyroid peroxidase autoantibodies (TPOAb) and thyroglobulin autoantibodies (TGAb) and thyrotropin receptor autoantibodies (TRAb) in patients with Graves' disease (GD), Hashimoto's thyroiditis (HT) and T1DM patients with AITD.

METHODS

Totally, 389 patients with GD, 334 patients with HT, 108 T1DM patients with AITD and 115 healthy controls (HC) were recruited in the study. Islet autoantibodies (ZnT8A, GADA and IA-2A) were detected by radioligand binding assay. Thyroid autoantibodies, TPOAb and TGAb were detected by chemiluminescence assay, and TRAb was detected by RIA.

RESULTS

The prevalence of ZnT8A, GADA and IA-2A was higher in GD and HT patients than that of HC (ZnT8A: GD 8.48%, HT 10.8% vs HC 1.74%; GADA: GD 7.46%, HT 7.74% vs HC 0.870%; IA-2A: GD 4.88%, HT 3.59% vs HC 0%; All P < 0.05) but lower than that of T1DM subjects with AITD (ZnT8A: 42.6%; IA-2A: 44.4%; GADA: 74.1%; all P < 0.0001).

CONCLUSIONS

An increased prevalence of ZnT8A as well as GADA and IA-2A was found in both GD and HT patients, indicating that there is a potential link between thyroid autoimmunity and islet autoimmunity.

摘要

目的

1型糖尿病(T1DM)患者中最常见的共存器官特异性自身免疫性疾病是自身免疫性甲状腺疾病(AITD)。然而,基于大量人群的关于AITD患者中锌转运体8自身抗体(ZnT8A)和其他胰岛自身抗体患病率的临床报告很少。我们旨在探讨与格雷夫斯病(GD)、桥本甲状腺炎(HT)患者以及合并AITD的T1DM患者中的甲状腺自身抗体、甲状腺过氧化物酶自身抗体(TPOAb)、甲状腺球蛋白自身抗体(TGAb)和促甲状腺素受体自身抗体(TRAb)相比,胰岛自身抗体、ZnT8A、谷氨酸脱羧酶自身抗体(GADA)和胰岛素瘤相关抗原2自身抗体(IA-2A)的存在情况。

方法

本研究共纳入389例GD患者、334例HT患者、108例合并AITD的T1DM患者和115例健康对照(HC)。采用放射配体结合法检测胰岛自身抗体(ZnT8A、GADA和IA-2A)。采用化学发光法检测甲状腺自身抗体、TPOAb和TGAb,采用放射免疫分析法检测TRAb。

结果

GD和HT患者中ZnT8A、GADA和IA-2A的患病率高于HC(ZnT8A:GD为8.48%,HT为10.8%,HC为1.74%;GADA:GD为7.46%,HT为7.74%,HC为0.870%;IA-2A:GD为4.88%,HT为3.59%,HC为0%;所有P<0.05),但低于合并AITD的T1DM患者(ZnT8A:42.6%;IA-2A:44.4%;GADA:74.1%;所有P<0.0001)。

结论

在GD和HT患者中均发现ZnT8A以及GADA和IA-2A的患病率增加,表明甲状腺自身免疫与胰岛自身免疫之间存在潜在联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59a4/8183620/d04e07c4003f/EC-20-0650fig1.jpg

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