Zecevic-Pasic Lamija, Tihic-Kapidzic Suzana, Hasanbegovic Snijezana, Begovic Ermin, Gojak Refet, Dzananovic Nejra
Department for Clinical biochemistry and immunology, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Paediatric Clinic, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Mater Sociomed. 2023 Sep;35(3):190-195. doi: 10.5455/msm.2023.35.190-195.
Diabetes mellitus type 1 (T1D) is an autoimmune organ-specific disease with a wide range of clinical manifestations, in which the β cells of the pancreatic islets of Langerhans are destroyed by the action of autoreactive T lymphocytes and the formation of autoantibodies against β cell components. Among used serological markers of T1D, anti-glutamic acid decarboxylase antibodies (GAD65), anti-tyrosine phosphatase antibodies (IA2), islet cell antibodies (ICA), insulin autoantibodies (IAA) and anti-zinc transporter antibodies (Zn-T8) are of great significance.
This study aimed to analyze presence of type 1 diabetes-related autoantibodies (GAD65, IA2, ICA, IAA and Zn-T8 and effects of age and gender on their occurrence in pediatric population.
Sixty seven (N=67) T1D pediatric patients were included in the study. The levels of immunological parameters such as anti-glutamic acid decarboxylase antibodies (GAD-Ab), anti-tyrosine phosphatase antibodies (IA2-Ab), islet cell antibodies (ICA) and insulin autoantibodies (IAA) were determined by chemiluminescence immunoassay (CLIA) and anti-zinc transporter antibodies (Zn-T8-Ab) were determined by enzyme-linked immunosorbent assay (ELISA). For statistical analysis, we used SPSS statistical program.
Our study revealed that among 67 patients with T1D (40 male and 27 female), with an average age of 12,1±3,9 years. The average age of diabetes diagnosis was 6,15±3,29 years. 24 (35,8%) cases were positive for GAD65, 15 (22,4%) for ICA, 34 (50,7%) for IAA, 16 (23,9%) for IA2 and 36 (53,7%) for Zn-T8. The largest number of patients had single positive antibody, the most dominated among them was IAA dominated (40,9%), then Zn-T8 (31,8%). According to Spearman correlation test Zn-transporter shows a significant positive correlation with age of the participants (p=0.027) and disease duration (p=0.006). Anti IA2 shows significant negative correlation with HbA1c (p=0.043). Zn-transporter is associated with patients age and duration of T1D.
In most cases, patients with T1D are positive for at least one of the specific autoantibodies. Zn-T8 is the most frequently detected and is an important serological marker of type 1 diabetes mellitus. Gender effects on autoantibodies seems to be insignificant, while age alongside disease duration shows important effects.
1型糖尿病（T1D）是一种具有广泛临床表现的自身免疫性器官特异性疾病，其中朗格汉斯胰岛的β细胞被自身反应性T淋巴细胞的作用以及针对β细胞成分的自身抗体的形成所破坏。在T1D常用的血清学标志物中，抗谷氨酸脱羧酶抗体（GAD65）、抗酪氨酸磷酸酶抗体（IA2）、胰岛细胞抗体（ICA）、胰岛素自身抗体（IAA）和抗锌转运体抗体（Zn-T8）具有重要意义。
本研究旨在分析1型糖尿病相关自身抗体（GAD65、IA2、ICA、IAA和Zn-T8）的存在情况以及年龄和性别对其在儿科人群中出现的影响。
67名T1D儿科患者纳入研究。采用化学发光免疫分析法（CLIA）测定抗谷氨酸脱羧酶抗体（GAD-Ab）、抗酪氨酸磷酸酶抗体（IA2-Ab）、胰岛细胞抗体（ICA）和胰岛素自身抗体（IAA）等免疫参数水平，采用酶联免疫吸附测定法（ELISA）测定抗锌转运体抗体（Zn-T8-Ab）。使用SPSS统计软件进行统计分析。
我们的研究显示，67例T1D患者（40例男性，27例女性），平均年龄为12.1±3.9岁。糖尿病诊断的平均年龄为6.15±3.29岁。24例（35.8%）GAD65阳性，15例（22.4%）ICA阳性，34例（50.7%）IAA阳性，16例（23.9%）IA2阳性，36例（53.7%）Zn-T8阳性。大多数患者有单一阳性抗体，其中以IAA为主（40.9%），其次是Zn-T8（3l.8%）。根据Spearman相关性检验，锌转运体与参与者年龄（p=0.027）和病程（p=0.006）呈显著正相关。抗IA2与糖化血红蛋白（HbA1c）呈显著负相关（p=0.043）。锌转运体与患者年龄和T1D病程相关。
在大多数情况下，T1D患者至少有一种特异性自身抗体呈阳性。Zn-T8是最常检测到的，是1型糖尿病的重要血清学标志物。性别对自身抗体的影响似乎不显著，而年龄和病程显示出重要影响。
