Study of the diagnostic efficiency of anti-ZnT8 autoantibodies for type 1 diabetes in pediatric patients.

Laboratory medicine Pub Date : 2024-05-02 DOI:10.1093/labmed/lmad079

Sandra Fuentes-Cantero, Concepción González-Rodríguez, Carmen Rodríguez-Chacón, Raquel Galvan-Toribio, Joaquín Hermosín-Escudero, Antonio Pérez-Pérez, Antonio León-Justel

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Abstract

Objective: Zinc transporter 8 autoantibodies (ZNt8A) are 1 of the 4 main autoantibodies used for the diagnosis of type 1 diabetes (T1D), with glutamic acid decarboxylase autoantibodies (GADA), islet antigen-2 autoantibodies (IA-2A), and insulin autoantibodies (IAA). The objective of this study is to evaluate the diagnostic efficiency of these autoantibodies for the diagnosis of T1D in pediatric patients.

Methods: A retrospective analysis of patients under 16 years of age with suspected T1D was made between June 2020 and January 2021. A total of 80 patients were included in the study, with 1 sample per patient. Subjects were classified according to diagnosis.

Results: Of the subjects included in the study, 50 developed T1D. The diagnostic efficacy was IA-2A (cutoff ≥ 28 U/L) sensitivity 0.26 (95% CI: 0.14-0.38) and specificity 0.97 (95% CI: 0.79-1.0); GADA (cutoff ≥ 17 U/mL) sensitivity 0.40 (95% CI: 0.26-0.54) and specificity 0.87 (95% CI: 0.75-0.99); ZnT8A (cut off ≥ 15 U/L) sensitivity 0.62 (95% CI: 0.49-0.75) and specificity 0.97 (95% CI: 0.90-1.0). ZnT8A obtained the most significantly global diagnostic accuracy (0.75), and GADA with ZnT8A showed the highest correlation.

Conclusion: The results obtained indicate a higher efficiency of anti-ZnT8 autoantibodies for the diagnosis of T1D in pediatric patients. Clinical efficiency of diabetic autoantibodies is method and assay dependent and influences combined diagnostic strategies.

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研究抗ZnT8自身抗体对儿童1型糖尿病的诊断效率。

目的：锌转运体8自身抗体（ZNt8A锌转运体8自身抗体（ZNt8A）与谷氨酸脱羧酶自身抗体（GADA）、胰岛抗原-2自身抗体（IA-2A）和胰岛素自身抗体（IAA）是诊断1型糖尿病（T1D）的4种主要自身抗体之一。本研究旨在评估这些自身抗体对诊断儿童T1D的有效性：2020年6月至2021年1月期间，对16岁以下疑似T1D患者进行了回顾性分析。研究共纳入 80 名患者，每名患者 1 份样本。研究对象根据诊断结果进行分类：结果：在纳入研究的受试者中，有 50 人罹患 T1D。诊断疗效为 IA-2A（临界值≥ 28 U/L）灵敏度为 0.26（95% CI：0.14-0.38），特异度为 0.97（95% CI：0.79-1.0）；GADA（临界值≥ 17 U/mL）灵敏度为 0.40（95% CI：0.26-0.54），特异性 0.87（95% CI：0.75-0.99）；ZnT8A（临界值≥ 15 U/L）敏感性 0.62（95% CI：0.49-0.75），特异性 0.97（95% CI：0.90-1.0）。ZnT8A的全局诊断准确率最高（0.75），GADA与ZnT8A的相关性最高：结论：研究结果表明，抗 ZnT8 自身抗体诊断儿童 T1D 的效率更高。糖尿病自身抗体的临床效率取决于方法和检测手段，并影响联合诊断策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Laboratory medicine

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