The Prevalence of Islet Autoantibodies in Thai Juvenile-onset Type 1 Diabetes.

BACKGROUND: Type 1 diabetes mellitus (T1DM) is caused by autoimmune destruction of islet β-cells of pancreas. Now, there are overlapping phenotypes in a significant proportion of youth with type 1 and 2 diabetes. Thus, positive pancreatic autoantibodies are helpful to diagnose T1DM. Zinc Transporter 8 antibody (ZnT8A) is a recently identified autoantibody in T1DM and no data of ZnT8A in Thai population have been reported.

METHODS: We aim to estimate the prevalence of ZnT8A in Thai juvenile-onset T1DM and to evaluate its diagnostic value relative to glutamic acid decarboxylase and insulinoma-2 antigen antibodies (GADA and IA2A). A cross-sectional study of patients with T1DM diagnosed before age 15 years, and disease duration <10 years were enrolled. ZnT8A, GADA, and IA2A were measured in sera by commercial ELISA kits.

RESULTS: A total of 81 youth (30 boys and 51 girls) aged 12.3 ± 4.5 years with T1DM were included. The median diabetes duration was 3 years (range 0-10). The prevalence of ZnT8A, GADA, and IA2A were 54.3%, 75.3%, and 45.7%, respectively. ZnT8A were detected in 16% of T1DM patients negative for both GADA and IA2A. Combination of ZnT8A, GADA and IA2A could detect 80.2% of patients with T1DM. Combined use of ZnT8A and GADA identified 100% of antibody-positive patients.

CONCLUSION: The prevalence of ZnT8A in Thai juvenile-onset T1DM appears to be higher than in previous studies from Asia. ZnT8A could replace IA2A as an autoimmunity marker in Thai pediatric T1DM patients with better diagnostic performance. This article is protected by copyright. All rights reserved.