Islet autoantibody frequency in relatives of children with type 1 diabetes who have a type 2 diabetes diagnosis

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2024-06-27 DOI:10.1111/dme.15394

Shanice J. Lewis, Claire L. Williams, Georgina L. Mortimer, AWAF, BOX Study Group, Richard A. Oram, William A. Hagopian, Kathleen M. Gillespie, Anna E. Long

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Abstract

Aim

This study aimed to evaluate characteristics of autoimmunity in individuals who have a type 2 diagnosis and are relatives of children with type 1 diabetes.

Methods

Pre-diagnosis samples (median 17 months before onset) from relatives who were later diagnosed with type 2 diabetes were measured for autoantibodies to glutamate decarboxylase 65 (GADA), islet antigen-2 (IA-2A), zinc transporter 8 (ZnT8A) and insulin (IAA) as well as the type 1 diabetes genetic risk score (GRS2). Associations between islet autoantibodies, insulin treatment and GRS2 were analysed using Fisher's exact and t-tests.

Results

Among 226 relatives (64% men; mean age at sampling 41 years; mean age 54 years at diagnosis), 32 (14%) were islet autoantibody-positive for at least one autoantibody more than a decade before diagnosis. Approximately half of these (n = 15) were treated with insulin. GADA-positivity was higher in insulin-treated relatives than in non-insulin-treated relatives (12/18 [67%] vs. 6/18 [33%], p < 0.001). IAA-positivity was observed in 13/32 (41%) of relatives with autoantibodies. GRS2 scores were increased in autoantibody-positive relatives (p = 0.032), but there was no clear evidence for a difference according to treatment (p = 0.072).

Conclusion

This study highlights the importance of measuring islet autoantibodies, including IAA, in relatives of people with type 1 diabetes to avoid misdiagnosis.

Abstract Image

查看原文本刊更多论文

确诊为 2 型糖尿病的 1 型糖尿病患儿亲属中的胰岛自身抗体频率。

目的：本研究旨在评估确诊为 2 型糖尿病的 1 型糖尿病患儿亲属的自身免疫特征：方法：对后来被诊断为2型糖尿病的亲属的诊断前样本（发病前中位数为17个月）进行谷氨酸脱羧酶65（GADA）、胰岛抗原-2（IA-2A）、锌转运体8（ZnT8A）和胰岛素（IAA）自身抗体以及1型糖尿病遗传风险评分（GRS2）的测定。用费雪精确检验和t检验分析了胰岛自身抗体、胰岛素治疗和GRS2之间的关联：在 226 名亲属（64% 为男性；取样时平均年龄为 41 岁；确诊时平均年龄为 54 岁）中，有 32 人（14%）在确诊前十多年至少有一种胰岛自身抗体呈阳性。其中约一半（15 人）接受过胰岛素治疗。接受过胰岛素治疗的亲属中 GADA 阳性率高于未接受过胰岛素治疗的亲属（12/18 [67%] vs. 6/18 [33%]，P 结论：本研究强调了测量1型糖尿病患者亲属胰岛自身抗体（包括IAA）以避免误诊的重要性。

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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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”