波斯尼亚和黑塞哥维那儿童人群中1型糖尿病相关自身抗体的存在。

Lamija Zecevic-Pasic, Suzana Tihic-Kapidzic, Snijezana Hasanbegovic, Ermin Begovic, Refet Gojak, Nejra Dzananovic
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引用次数: 0

摘要

背景:1型糖尿病(T1D)是一种自身免疫性器官特异性疾病,临床表现广泛,胰岛β细胞被自身反应性T淋巴细胞的作用和针对β细胞成分的自身抗体的形成所破坏。在所使用的T1D血清学标志物中,抗谷氨酸脱羧酶抗体(GAD65)、抗酪氨酸磷酸酶抗体(IA2)、胰岛细胞抗体(ICA)、胰岛素自身抗体(IAA)和抗锌转运蛋白抗体(Zn-T8)具有重要意义。目的:分析1型糖尿病相关自身抗体(GAD65、IA2、ICA、IAA和Zn-T8)在儿科人群中的存在,以及年龄和性别对其发生的影响。用化学发光免疫分析法(CLIA)测定抗谷氨酸脱羧酶抗体(GAD-Ab)、抗酪氨酸磷酸酶抗体(IA2-Ab),胰岛细胞抗体(ICA)和胰岛素自身抗体(IAA)等免疫参数水平,用酶联免疫吸附法(ELISA)测定抗锌转运蛋白抗体(Zn-T8-Ab)水平。为了进行统计分析,我们使用了SPSS统计程序。结果:我们的研究显示,在67名T1D患者中(40名男性和27名女性),平均年龄为12,1±3.9岁。诊断为糖尿病的平均年龄为6,15±3.29岁。GAD65阳性24例(35.8%),ICA阳性15例(22.4%),IAA阳性34例(50.7%),IA2阳性16例(23.9%),Zn-T8阳性36例(53.7%)。单个抗体阳性的患者最多,其中IAA为主(40,9%),其次是Zn-T8(31,8%)。根据Spearman相关性测试,锌转运蛋白与参与者的年龄(p=0.027)和疾病持续时间(p=0.006)呈显著正相关。抗IA2与HbA1c呈显著负相关(p=0.043)。锌转运蛋白和患者的年龄和T1D持续时间相关。结论:在大多数情况下,T1D患者对至少一种特异性自身抗体呈阳性。Zn-T8是最常检测到的,是1型糖尿病的重要血清学标志物。性别对自身抗体的影响似乎是微不足道的,而年龄和疾病持续时间显示出重要的影响。
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Presence of Type 1 Diabetes-Related Autoantibodies in Pediatric Population in Bosnia and Herzegovina.

Background: Diabetes mellitus type 1 (T1D) is an autoimmune organ-specific disease with a wide range of clinical manifestations, in which the β cells of the pancreatic islets of Langerhans are destroyed by the action of autoreactive T lymphocytes and the formation of autoantibodies against β cell components. Among used serological markers of T1D, anti-glutamic acid decarboxylase antibodies (GAD65), anti-tyrosine phosphatase antibodies (IA2), islet cell antibodies (ICA), insulin autoantibodies (IAA) and anti-zinc transporter antibodies (Zn-T8) are of great significance.

Objective: This study aimed to analyze presence of type 1 diabetes-related autoantibodies (GAD65, IA2, ICA, IAA and Zn-T8 and effects of age and gender on their occurrence in pediatric population.

Methods: Sixty seven (N=67) T1D pediatric patients were included in the study. The levels of immunological parameters such as anti-glutamic acid decarboxylase antibodies (GAD-Ab), anti-tyrosine phosphatase antibodies (IA2-Ab), islet cell antibodies (ICA) and insulin autoantibodies (IAA) were determined by chemiluminescence immunoassay (CLIA) and anti-zinc transporter antibodies (Zn-T8-Ab) were determined by enzyme-linked immunosorbent assay (ELISA). For statistical analysis, we used SPSS statistical program.

Results: Our study revealed that among 67 patients with T1D (40 male and 27 female), with an average age of 12,1±3,9 years. The average age of diabetes diagnosis was 6,15±3,29 years. 24 (35,8%) cases were positive for GAD65, 15 (22,4%) for ICA, 34 (50,7%) for IAA, 16 (23,9%) for IA2 and 36 (53,7%) for Zn-T8. The largest number of patients had single positive antibody, the most dominated among them was IAA dominated (40,9%), then Zn-T8 (31,8%). According to Spearman correlation test Zn-transporter shows a significant positive correlation with age of the participants (p=0.027) and disease duration (p=0.006). Anti IA2 shows significant negative correlation with HbA1c (p=0.043). Zn-transporter is associated with patients age and duration of T1D.

Conclusion: In most cases, patients with T1D are positive for at least one of the specific autoantibodies. Zn-T8 is the most frequently detected and is an important serological marker of type 1 diabetes mellitus. Gender effects on autoantibodies seems to be insignificant, while age alongside disease duration shows important effects.

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