Clinical Utility and Outcome Prediction of Early ZnT8-IgG Testing and Titer in Type 1 Diabetes
| Autor: | Amanda R, Dahl, Sarah Jenkins, M, Sean J, Pittock, Siobhan, Pittock |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Journal of Clinical Research in Pediatric Endocrinology. 15:35-41 |
| ISSN: | 1308-5735 1308-5727 |
| Popis: | Type 1 diabetes autoantibodies are directed against multiple antigens including: glutamic acid decarboxylase (GAD65), protein tyrosine phosphatase-like islet antigen 2 (IA2), insulin (IAA), and Zinc transporter 8 protein (ZnT8). The aim of our study was to determine if the presence or titer of ZnT8 antibodies (Ab) was predictive of clinical presentation at diagnosis or subsequent disease course.Between January 2003 and May 2019, 105 patients aged ≤21 years with a clinical diagnosis of T1DM had at least 1 autoantibody measured. Retrospective chart review was completed. At diagnosis, we evaluated BMI z-score, HbA1c, and the presence of DKA. Complications analyzed post-diagnosis included episodes of DKA, diagnosis of autoimmune (AI) disease, and the presence of vascular complications. We evaluated cumulative lifetime excess glucose as HbA1c AUC6%.71 patients were ZnT8-Ab(+) (68%), with 19 having low titer ZnT8-Ab and 52 high titer ZnT8-Ab. Follow-up ranged from 10 days to 15.7 years, (median 2.08 years). There were no differences in characteristics at disease onset or in subsequent follow up between those with and without ZnT8 Ab or those with high or low titers of ZnT8 Ab except for a small but statistically significant difference in cumulative excess glucose (HbA1c AUC6%) between those with low and high titers (p=0.0095).Our study adds to the limited literature on the effect of the presence and titer of ZnT8Ab in pediatric diabetes. The small effect of ZnT8-Ab titer on glucose excess as measured by HbA1c AUC warrants further study. |
| Databáze: | OpenAIRE |
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