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

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

机构地区：[1]Department of Endocrinology,Children’s Hospital Federico Gomez,Mexico 06720,Mexico [2]National Medical Center"Siglo XXI",UMAE Hosp Especialidades,Unidad Invest Med Epidemiol Clin,Mexican Social Security Institute,Mexico 06720,Mexico [3]Research Division,UMAE Hospital de Especialidades,Centro Médico Nacional Siglo XXI,Mexican Institute of Social Security,Mexico 06720,Mexico [4]Epidemiology Research Unit in Endocrinology and Nutrition,Federico Gómez Children’s Hospital,Mexico 06720,Mexico [5]Department of Endocrinology,Comprehensive Health Unit for Trans Persons,Mexico 11340,Mexico

出　　处：《World Journal of Diabetes》2024年第8期1717-1725,共9页世界糖尿病杂志（英文版）（电子版）

基　　金：Supported by Mexican Federal Funds HIM,No.2018/068 SSA152.

摘　　要：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'sχ2 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.

关 键 词：DIABETES OBESITY Adolescents AUTOIMMUNITY Beta cell Insulin requirements 

分 类 号：R587.1[医药卫生—内分泌]