Autoantibodies against beta cells to predict early insulin requirements in pediatric patients with clinically diagnosed type 2 diabetes.

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2024-08-15 DOI:10.4239/wjd.v15.i8.1717

Jorge M Molina, Patricia G Medina, Rita A Gomez, Julia R Herrera, Nancy L Martínez, Brenda Hernández, Yesenia García

{"title":"Autoantibodies against beta cells to predict early insulin requirements in pediatric patients with clinically diagnosed type 2 diabetes.","authors":"Jorge M Molina, Patricia G Medina, Rita A Gomez, Julia R Herrera, Nancy L Martínez, Brenda Hernández, Yesenia García","doi":"10.4239/wjd.v15.i8.1717","DOIUrl":null,"url":null,"abstract":"Background: Autoimmunity has emerged as a probable disease modifier in patients with clinically diagnosed type 2 diabetes mellitus (T2DM), that is, patients who have insulin resistance, obesity, and other cardiovascular risk factors, suggesting that the presence of glutamic acid decarboxylase (anti-GAD65), islet antigen 2 (anti-IA2), and zinc transporter 8 (anti-Zn8T) antibodies could have deleterious effects on beta cell function, causing failure and earlier requirement for insulin treatment.Aim: To evaluate anti-GAD65, anti-IA2 and anti-Zn8T as predictors of early insulin requirement in adolescents with a clinical diagnosis of T2DM.Methods: This was a case-control study in patients with clinically diagnosed with T2DM (68 cases and 64 controls with and without early insulin dependence respectively), male and female, aged 12-18 years. Somatometry, blood pressure, glucose, insulin, C-peptide, glycated hemoglobin A1c, and lipid profiles were assessed. ELISA was used to measure anti-GAD65, anti-IA2, and anti-Zn8T antibodies. Descriptive statistics, Pearson's χ 2 test, Student's t test, and logistic regression was performed. P < 0.05 was considered statistically significant.Results: There were 132 patients (53.8% female), with a mean age was 15.9 ± 1.3 years, and there was a disease evolution time of 4.49 ± 0.88 years. The presence of anti-GAD65, anti-IA2, and anti-Zn8T positivity was found in 29.5%, 18.2%, and 15.9%, respectively. Dividing the groups by early or no insulin dependence showed that the group with insulin had a higher frequency of antibody positivity: anti-GAD65 odds ratio (OR): 2.42 (1.112-5.303, P = 0.026); anti-IA2: OR: 1.55 (0.859-2.818, P = 0.105); and anti-Zn8T: OR: 7.32 (2.039-26.279, P = 0.002).Conclusion: Anti-GAD65 positivity was high in our study. Anti-GAD65 and anti-Zn8T positivity showed a significantly depleted beta cell reserve phenotype, leading to an increased risk of early insulin dependence.","PeriodicalId":48607,"journal":{"name":"World Journal of Diabetes","volume":"15 8","pages":"1717-1725"},"PeriodicalIF":4.2000,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346091/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Diabetes","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4239/wjd.v15.i8.1717","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Autoimmunity has emerged as a probable disease modifier in patients with clinically diagnosed type 2 diabetes mellitus (T2DM), that is, patients who have insulin resistance, obesity, and other cardiovascular risk factors, suggesting that the presence of glutamic acid decarboxylase (anti-GAD65), islet antigen 2 (anti-IA2), and zinc transporter 8 (anti-Zn8T) antibodies could have deleterious effects on beta cell function, causing failure and earlier requirement for insulin treatment.

Aim: To evaluate anti-GAD65, anti-IA2 and anti-Zn8T as predictors of early insulin requirement in adolescents with a clinical diagnosis of T2DM.

Methods: This was a case-control study in patients with clinically diagnosed with T2DM (68 cases and 64 controls with and without early insulin dependence respectively), male and female, aged 12-18 years. Somatometry, blood pressure, glucose, insulin, C-peptide, glycated hemoglobin A1c, and lipid profiles were assessed. ELISA was used to measure anti-GAD65, anti-IA2, and anti-Zn8T antibodies. Descriptive statistics, Pearson's χ ² test, Student's t test, and logistic regression was performed. P < 0.05 was considered statistically significant.

Results: There were 132 patients (53.8% female), with a mean age was 15.9 ± 1.3 years, and there was a disease evolution time of 4.49 ± 0.88 years. The presence of anti-GAD65, anti-IA2, and anti-Zn8T positivity was found in 29.5%, 18.2%, and 15.9%, respectively. Dividing the groups by early or no insulin dependence showed that the group with insulin had a higher frequency of antibody positivity: anti-GAD65 odds ratio (OR): 2.42 (1.112-5.303, P = 0.026); anti-IA2: OR: 1.55 (0.859-2.818, P = 0.105); and anti-Zn8T: OR: 7.32 (2.039-26.279, P = 0.002).

Conclusion: Anti-GAD65 positivity was high in our study. Anti-GAD65 and anti-Zn8T positivity showed a significantly depleted beta cell reserve phenotype, leading to an increased risk of early insulin dependence.

查看原文本刊更多论文

预测临床诊断为 2 型糖尿病的儿科患者早期胰岛素需求的β细胞自身抗体。

背景：谷氨酸脱羧酶（抗-GAD65）、胰岛抗原2（抗-IA2）和锌转运体8（抗-Zn8T）抗体的存在可能对β细胞功能产生有害影响，导致胰岛素治疗失败和更早需要胰岛素。目的：评估抗GAD65、抗IA2和抗Zn8T抗体对临床诊断为T2DM的青少年早期胰岛素需求的预测作用：这是一项病例对照研究，研究对象是临床诊断为 T2DM 的患者（68 例病例和 64 例对照，分别有和没有早期胰岛素依赖），男女均有，年龄在 12-18 岁之间。研究人员对患者的体格测量、血压、血糖、胰岛素、C 肽、糖化血红蛋白 A1c 和血脂状况进行了评估。采用 ELISA 方法测量抗 GAD65、抗 IA2 和抗 Zn8T 抗体。进行了描述性统计、Pearson's χ 2 检验、Student's t 检验和逻辑回归。P<0.05为差异有统计学意义：共有 132 名患者（53.8% 为女性），平均年龄为（15.9±1.3）岁，疾病演变时间为（4.49±0.88）年。抗GAD65、抗IA2和抗Zn8T阳性率分别为29.5%、18.2%和15.9%。按是否早期依赖胰岛素进行分组显示，依赖胰岛素组的抗体阳性率更高：抗-GAD65几率比（OR）：2.42（1.112-5.303，P = 0.026）；抗-IA2：OR：1.55（0.859-2.818，P = 0.105）；抗-Zn8T：OR：7.32（2.039-26.279，P = 0.002）：结论：在我们的研究中，抗 GAD65 阳性率较高。结论：在我们的研究中，抗 GAD65 阳性率较高。抗 GAD65 和抗 Zn8T 阳性率显示β细胞储备表型明显耗竭，导致早期胰岛素依赖的风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.