基于人群的2型糖尿病患者中的1型糖尿病、乳糜泻和自身免疫性甲状腺炎自身抗体。
Type 1 diabetes, celiac disease, and autoimmune thyroiditis autoantibodies in population-based type 2 diabetes patients.
作者信息
Alexander Lind, Cheng-Ting Tsai, Åke Lernmark, Johan Jendle
机构信息
Department of Clinical Sciences Malmö, Lund University CRC, Skåne University Hospital, Malmö, Sweden.
Enable Biosciences Inc., South San Francisco, CA, USA.
出版信息
J Clin Transl Endocrinol. 2024 Sep 6;37:100367. doi: 10.1016/j.jcte.2024.100367. eCollection 2024 Sep.
AIMS
The study aims were to determine autoantibodies associated with type 1 diabetes (T1D), celiac disease (CD) and autoimmune thyroid disease (AITD) in individuals living with type 2 diabetes (T2D) compared to T1D and matched controls.
METHODS
Individuals with T1D and T2D were randomly identified in health-care registers. Blood was collected through home-capillary sampling and autoantibodies associated with either T1D against glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma antigen-2 (IA-2A), and zinc transporter 8 (ZnT8A), CD against tissue transglutaminase (tTGA) or AITD against thyroid peroxidase (TPOA) were determined in an automated, multiplex Antibody Detection by Agglutination-PCR (ADAP) assay.
RESULTS
GADA were detected in 46 % (88/191) of T1D and increased to 6.2 % (23/372) in T2D compared to 2.6 % (7/259) of controls (p = 0.0367). tTGA was low (1.1-2.6 %) and not different in between the study cohorts, nonetheless, in T1D tTGA was associated to islet autoantibodies. TPOA was more frequent in T1D, 27.1 % (53/191), compared to either T2D, 14.8 % (55/372; p = 0.0002) or controls, 14.3 % (37/259) (p = 0.0004). Overall, TPOA was more frequent in GADA positive (34.8 %; 8/23) than negative (13.5 %; 47/349; p = 0.0053) T2D individuals.
CONCLUSION
It's suggested that analyzing GADA and TPOA may refine the autoimmune landscape in individuals clinically classified as T2D.
目的
本研究旨在确定与1型糖尿病（T1D）、乳糜泻（CD）和自身免疫性甲状腺疾病（AITD）相关的自身抗体，研究对象为2型糖尿病（T2D）患者，并与T1D患者及匹配的对照组进行比较。
方法
通过医疗保健登记册随机确定T1D和T2D患者。通过家庭毛细血管采血收集血液，并采用自动多重凝集聚合酶链反应抗体检测（ADAP）法测定与T1D相关的抗谷氨酸脱羧酶（GADA）、胰岛素（IAA）、胰岛瘤抗原2（IA-2A）和锌转运体8（ZnT8A）的自身抗体，与CD相关的抗组织转谷氨酰胺酶（tTGA）的自身抗体，或与AITD相关的抗甲状腺过氧化物酶（TPOA）的自身抗体。
结果
GADA在46%（88/191）的T1D患者中被检测到，在T2D患者中升至6.2%（23/372），而在对照组中为2.6%（7/259）（p = 0.0367）。tTGA水平较低（1.1 - 2.6%），在各研究队列之间无差异，尽管如此，在T1D中tTGA与胰岛自身抗体相关。TPOA在T1D中更常见，为27.1%（53/191），而在T2D中为14.8%（55/372；p = 0.0002），在对照组中为14.3%（37/259）（p = 0.0004）。总体而言，在GADA阳性的T2D个体中TPOA更常见（34.8%；8/23），而在GADA阴性的个体中为13.5%（47/349；p = 0.0053）。
结论
建议分析GADA和TPOA可能有助于完善临床诊断为T2D个体的自身免疫情况。
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