ZnT8自身抗体在2型糖尿病青年患者中的患病率较低，并与较高的胰岛素敏感性、较低的胰岛素分泌和较低的倾向指数相关

IF 4.2 Q1 ENDOCRINOLOGY & METABOLISM Journal of Clinical and Translational Endocrinology Pub Date : 2022-09-01 DOI:10.1016/j.jcte.2022.100300

Janine Higgins , Philip Zeitler , Kimberly L. Drews , Silva Arslanian , Kenneth Copeland , Robin Goland , Georgeanna Klingensmith , Terri H. Lipman , Sherida Tollefsen , for the TODAY Study Group

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引用次数: 1

摘要

AimZnT8自身抗体阳性(ZnT8+)与成人1型糖尿病和代谢并发症的风险相关。我们的目的是评估ZnT8 +在青少年和青年(TODAY)队列T2D治疗中的患病率，并描述相关的表型结果。方法参与者年龄为13.98±2.03岁，确诊为T2D, BMI百分位数为97.69±3.32(64%为女性)，基线时GAD-和IA2-。在基线和研究结束时检测ZnT8自身抗体。结果687人(0.29%)为ZnT8 +， 1人(0.15%)从ZnT8-转化为ZnT8 +。与TODAY队列和ZnT8A-个体相比，ZnT8A +个体的HbA1c、HDL和LDL胆固醇和IL-1β浓度较高，BMI、IL-6和甘油三酯浓度较低。他们也有较高的胰岛素敏感性，较低的胰岛素分泌和处置指数，代谢类似于T1D。所有ZnT8 +的参与者在随机治疗中都经历了血糖控制的丧失，但表现出比其他组更低的糖尿病并发症发生率。结论考虑到ZnT8 +个体的低并发症发生率，ZnT8可能不会影响该人群的临床病程。

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ZnT8 autoantibody prevalence is low in youth with type 2 diabetes and associated with higher insulin sensitivity, lower insulin secretion, and lower disposition index

Aim

ZnT8 autoantibody positivity (ZnT8+) is associated with risk for type 1 diabetes and with metabolic complications in adults. Our aim was to assess prevalence of ZnT8 + in the Treatment of T2D in Adolescents and Youth (TODAY) cohort and describe associated phenotypic outcomes.

Methods

TODAY participants were 13.98 ± 2.03 years with a confirmed diagnosis of T2D, BMI percentile of 97.69 ± 3.32 (64% female), and GAD- and IA2- at baseline. ZnT8 autoantibodies were measured at baseline and end of study.

Results

3 of 687 participants (0.29%) were ZnT8 + and there was one conversion (0.15%) from ZnT8- to ZnT8 + during the study. ZnT8A + individuals had higher HbA1c, HDL and LDL cholesterol, and IL-1β concentrations, and lower BMI, IL-6, and triglyceride concentrations compared to the TODAY cohort and ZnT8A- individuals. They also had higher insulin sensitivity with lower insulin secretion and disposition index, metabolically resembling T1D. All ZnT8 + participants experienced loss of glycemic control on randomized treatment, but exhibited lower rates of diabetic complications than other groups.