{"title":"30岁前诊断为1型糖尿病的泰国人的胰岛自身抗体：一项大型多中心全国性研究","authors":"Nattachet Plengvidhya, Sarocha Suthon, Tassanee Nakdontri, Nipaporn Teerawattanapong, Saranya Ingnang, Watip Tangjittipokin","doi":"10.1007/s00125-025-06373-y","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Aims/hypothesis</h3><p>Type 1 diabetes is categorised into autoantibody positive and autoantibody negative. Most type 1 diabetes research has focused on European populations, leaving a gap in understanding in relation to other ethnic groups, including Thai populations. This lack of data is significant given Thailand’s poor prevention and therapeutic management strategies. We aimed to investigate the frequency and distribution of islet autoantibodies among Thai individuals with long-standing type 1 diabetes diagnosed before the age of 30 years.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted a nationwide population-based study involving 48 hospitals in Thailand from May 2020 to September 2023, enrolling 953 participants. Demographic and clinical characteristics of individuals with autoantibody-positive and -negative type 1 diabetes were analysed. The autoantibodies GAD65, IA-2 and ZnT8 were measured using ELISA. A random C-peptide level was detected by electrochemiluminescence immunoassay.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Thai individuals with autoantibody-negative type 1 diabetes comprised 34.2% of the population. Among all individuals, the frequency of GAD65, IA-2 and ZnT8 was 56%, 37% and 33%, respectively. Autoantibody-negative individuals with type 1 diabetes were older at diagnosis, had higher BMI and had higher random C-peptide levels compared with autoantibody-positive individuals with type 1 diabetes. Female individuals had a higher prevalence of type 1 diabetes than male individuals (58% vs 42%; <i>p</i>=1.531 × 10<sup>−5</sup>). The southern region of Thailand exhibited a distinct pattern of autoantibody frequency compared with other regions (<i>p</i>=0.0001561).</p><h3 data-test=\"abstract-sub-heading\">Conclusions/interpretation</h3><p>The frequency, distribution and characteristics of autoantibody-positive and -negative long-standing type 1 diabetes in Thailand showed uniqueness from other populations. This provides insight into the disease that may have implications for type 1 diabetes prediction, treatment and pathogenesis, especially in the Southeast Asian population.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>\n","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"14 1","pages":""},"PeriodicalIF":8.4000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Islet autoantibodies in Thai individuals individuals diagnosed with type 1 diabetes before 30 years of age: a large multicentre nationwide study\",\"authors\":\"Nattachet Plengvidhya, Sarocha Suthon, Tassanee Nakdontri, Nipaporn Teerawattanapong, Saranya Ingnang, Watip Tangjittipokin\",\"doi\":\"10.1007/s00125-025-06373-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Aims/hypothesis</h3><p>Type 1 diabetes is categorised into autoantibody positive and autoantibody negative. Most type 1 diabetes research has focused on European populations, leaving a gap in understanding in relation to other ethnic groups, including Thai populations. This lack of data is significant given Thailand’s poor prevention and therapeutic management strategies. We aimed to investigate the frequency and distribution of islet autoantibodies among Thai individuals with long-standing type 1 diabetes diagnosed before the age of 30 years.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>We conducted a nationwide population-based study involving 48 hospitals in Thailand from May 2020 to September 2023, enrolling 953 participants. Demographic and clinical characteristics of individuals with autoantibody-positive and -negative type 1 diabetes were analysed. The autoantibodies GAD65, IA-2 and ZnT8 were measured using ELISA. A random C-peptide level was detected by electrochemiluminescence immunoassay.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Thai individuals with autoantibody-negative type 1 diabetes comprised 34.2% of the population. Among all individuals, the frequency of GAD65, IA-2 and ZnT8 was 56%, 37% and 33%, respectively. Autoantibody-negative individuals with type 1 diabetes were older at diagnosis, had higher BMI and had higher random C-peptide levels compared with autoantibody-positive individuals with type 1 diabetes. Female individuals had a higher prevalence of type 1 diabetes than male individuals (58% vs 42%; <i>p</i>=1.531 × 10<sup>−5</sup>). 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引用次数: 0
摘要
目的/假设1型糖尿病分为自身抗体阳性和自身抗体阴性。大多数1型糖尿病的研究都集中在欧洲人群上，对包括泰国人在内的其他种族群体的了解存在空白。鉴于泰国糟糕的预防和治疗管理战略，这种数据的缺乏意义重大。我们的目的是调查30岁以前诊断为长期1型糖尿病的泰国个体中胰岛自身抗体的频率和分布。方法：我们于2020年5月至2023年9月在泰国48家医院开展了一项全国性的基于人群的研究，纳入了953名参与者。分析自身抗体阳性和阴性1型糖尿病患者的人口学和临床特征。采用ELISA法检测自身抗体GAD65、IA-2和ZnT8。采用电化学发光免疫分析法随机检测c肽水平。结果泰国自身抗体阴性的1型糖尿病患者占总人口的34.2%。在所有个体中，GAD65、IA-2和ZnT8的频率分别为56%、37%和33%。与自身抗体阳性的1型糖尿病患者相比，自身抗体阴性的1型糖尿病患者在诊断时年龄较大，BMI较高，随机c肽水平较高。女性个体的1型糖尿病患病率高于男性个体(58% vs 42%；p=1.531 × 10−5)。与其他地区相比，泰国南部地区表现出明显的自身抗体频率模式（p=0.0001561）。结论/解释泰国长期存在的1型糖尿病自身抗体阳性和阴性的频率、分布和特征与其他人群相比具有独特性。这为1型糖尿病的预测、治疗和发病机制提供了新的思路，特别是在东南亚人群中。图形抽象
Islet autoantibodies in Thai individuals individuals diagnosed with type 1 diabetes before 30 years of age: a large multicentre nationwide study
Aims/hypothesis
Type 1 diabetes is categorised into autoantibody positive and autoantibody negative. Most type 1 diabetes research has focused on European populations, leaving a gap in understanding in relation to other ethnic groups, including Thai populations. This lack of data is significant given Thailand’s poor prevention and therapeutic management strategies. We aimed to investigate the frequency and distribution of islet autoantibodies among Thai individuals with long-standing type 1 diabetes diagnosed before the age of 30 years.
Methods
We conducted a nationwide population-based study involving 48 hospitals in Thailand from May 2020 to September 2023, enrolling 953 participants. Demographic and clinical characteristics of individuals with autoantibody-positive and -negative type 1 diabetes were analysed. The autoantibodies GAD65, IA-2 and ZnT8 were measured using ELISA. A random C-peptide level was detected by electrochemiluminescence immunoassay.
Results
Thai individuals with autoantibody-negative type 1 diabetes comprised 34.2% of the population. Among all individuals, the frequency of GAD65, IA-2 and ZnT8 was 56%, 37% and 33%, respectively. Autoantibody-negative individuals with type 1 diabetes were older at diagnosis, had higher BMI and had higher random C-peptide levels compared with autoantibody-positive individuals with type 1 diabetes. Female individuals had a higher prevalence of type 1 diabetes than male individuals (58% vs 42%; p=1.531 × 10−5). The southern region of Thailand exhibited a distinct pattern of autoantibody frequency compared with other regions (p=0.0001561).
Conclusions/interpretation
The frequency, distribution and characteristics of autoantibody-positive and -negative long-standing type 1 diabetes in Thailand showed uniqueness from other populations. This provides insight into the disease that may have implications for type 1 diabetes prediction, treatment and pathogenesis, especially in the Southeast Asian population.
期刊介绍：
Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.
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