Endocrinology and Diabetes Unit, Lady Ridgeway Hospital, Colombo, Sri Lanka.
FIRS Laboratories, RSR Ltd., Cardiff, United Kingdom.
Front Endocrinol (Lausanne). 2023 Feb 6;14:1028285. doi: 10.3389/fendo.2023.1028285. eCollection 2023.
There is limited information about diabetes and thyroid related autoantibodies in children with type 1 diabetes (T1D) or their siblings in Sri Lanka.
To assess in T1D children and their unaffected siblings the prevalence of autoantibodies to (1) glutamic acid decarboxylase (GADA), insulinoma associated antigen-2 (IA-2A) and zinc transporter 8 (ZnT8A) using 3 Screen ICA™ (3-Screen) and individual ELISA assays; (2) insulin (IAA); and (3) thyroid peroxidase (TPOA), thyroglobulin (TgA) and the TSH receptor (TSHRA).
We selected - (a) consecutive T1D children, and (b) their unaffected siblings of both sexes, from the T1D Registry at Lady Ridgeway Hospital, Colombo.
The median age (IQR) of 235 T1D children and 252 unaffected siblings was 11 (8.4, 13.2) and 9 (5.4, 14.9) years respectively, and the duration of T1D was 23 (7, 54) months. (1) T1D children (a) 79.1% were 3-Screen positive; (b) all 3-Screen positives were individual antibody positive (GADA in 74%; IA-2A 31.1%; ZnT8A 38.7%); (c) and were younger (p=0.01 vs 3-Screen negatives); (d) multiple autoantibodies were present in 45.1%; (e) IA-2A (p=0.002) and ZnT8A (p=0.006) prevalence decreased with T1D duration. (f) TPOA and TgA prevalence was higher in T1D children compared to unaffected siblings (28%, p=0.001 and 31%, p=0.004, respectively). (2) Unaffected siblings (a) 6.3% were 3-Screen positive (p=0.001 vs T1D), and 2.4% were positive for IAA; (b) four subjects had two diabetes related autoantibodies, one of whom developed dysglycaemia during follow-up.
The 3-Screen assay, used for the first time in Sri Lankan T1D children and their siblings as a screening tool, shows a high prevalence of T1D related Abs with a high correlation with individual assays, and is also a helpful tool in screening unaffected siblings for future T1D risk. The higher prevalence of thyroid autoantibodies in T1D children is consistent with polyglandular autoimmunity.
在斯里兰卡，1 型糖尿病（T1D）患儿及其无病兄弟姐妹中，有关糖尿病和甲状腺相关自身抗体的信息有限。
使用 3 Screen ICA™（3-Screen）和个别 ELISA 检测评估 T1D 患儿及其无病同胞中（1）谷氨酸脱羧酶（GADA）、胰岛瘤相关抗原-2（IA-2A）和锌转运体 8（ZnT8A）自身抗体；（2）胰岛素（IAA）；（3）甲状腺过氧化物酶（TPOA）、甲状腺球蛋白（TgA）和促甲状腺激素受体（TSHRA）的患病率。
我们选择了（a）连续的 T1D 患儿，和（b）他们在科伦坡 Lady Ridgeway 医院 T1D 登记处的无病同胞，不论性别。
235 名 T1D 患儿和 252 名无病同胞的中位年龄（IQR）分别为 11（8.4，13.2）和 9（5.4，14.9）岁，T1D 的病程为 23（7，54）个月。（1）T1D 患儿（a）79.1%为 3-Screen 阳性；（b）所有 3-Screen 阳性者均为个别抗体阳性（GADA 为 74%；IA-2A 为 31.1%；ZnT8A 为 38.7%）；（c）且年龄较小（p=0.01 与 3-Screen 阴性者相比）；（d）45.1%存在多种自身抗体；（e）IA-2A（p=0.002）和 ZnT8A（p=0.006）的患病率随 T1D 病程而降低。（f）TPOA 和 TgA 在 T1D 患儿中的患病率高于无病同胞（分别为 28%，p=0.001 和 31%，p=0.004）。（2）无病同胞（a）6.3%为 3-Screen 阳性（p=0.001 与 T1D 相比），2.4%为 IAA 阳性；（b）4 名受试者有两种糖尿病相关自身抗体，其中一名在随访期间发生血糖异常。
在斯里兰卡 T1D 儿童及其兄弟姐妹中，首次将 3-Screen 检测用作筛查工具，显示出 T1D 相关 Abs 的高患病率，与个别检测具有高度相关性，也是筛查无病同胞未来 T1D 风险的有用工具。T1D 患儿甲状腺自身抗体的高患病率与多腺体自身免疫一致。
