Analysis of diabetes-associated autoantibodies in children and adolescents with autoimmune thyroid diseases

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Authors: Rydzewska, Marta / Michalak, Justyna / Bossowska, Anna / Chen, Shu / Black, Sarah / Powell, Michael / Furmaniak, Jadwiga / Rees Smith, Bernard / Bossowski, Artur

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Analysis of diabetes-associated autoantibodies in children and adolescents with autoimmune thyroid diseases

Marta Rydzewska

 / Justyna Michalak

 / Anna Bossowska

 / Shu Chen

 / Sarah Black

 / Michael Powell

 / Jadwiga Furmaniak

 / Bernard Rees Smith

 / Artur Bossowski

Published Online: 2019-03-23 | DOI: https://doi.org/10.1515/jpem-2018-0367

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Abstract

Background

Zinc transporter 8 autoantibodies (ZnT8Abs) together with glutamic acid decarboxylase autoantibodies (GADAbs), insulinoma antigen 2 autoantibodies (IA-2Abs) and insulin autoantibodies (IAbs) are markers of type 1 diabetes mellitus (T1DM). We studied the prevalence of ZnT8Ab in children with autoimmune thyroid diseases (AITDs) to assess the association of AITDs and T1DM at the serological level.

Methods

The study groups consisted of 44 children with Graves’ disease (GD), 65 children with Hashimoto’s thyroiditis (HT), 199 children with T1DM with or without AITDs and 58 control children. ZnT8Ab, GADAb, IA-2Ab, IAb, 21-hydroxylase autoantibodies (21-OHAbs) and acetylcholine receptor autoantibodies (AChRAbs) were measured.

Results

ZnT8Abs were found in 4/44 (9.1%) patients with GD, and 4/44 (9.1%) patients with GD were positive for GADAb. Of the 65 HT patients, six (9.2%) were positive for ZnT8Ab, while four (6.2%) were positive for GADAb. In the T1DM group, 128/199 (64%) of the patients were positive for ZnT8Ab, 133/199 (67%) for GADAb and 109/199 (55%) for IA-2Ab. One GD patient and one HT patient were positive for all the four diabetes-associated autoantibodies. Two HT patients were positive for three diabetes autoantibodies. Two GD (4.5%) and five HT (7.7%) patients were positive for 21-OHAb only. None of the patients had AChRAb. In the control group, 2/58 (3.4%) were positive for GADAb and 2/58 (3.4%) were positive for ZnT8Ab.

Conclusions

Diabetes-associated autoantibodies including ZnT8Ab were found in children and adolescents with GD and HT.

Keywords: autoantibodies; autoimmune thyroid disease (AITD); Graves’ disease; Hashimoto’s thyroiditis; type 1 diabetes mellitus; zinc transporter 8 autoantibodies (ZnT8Ab)

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About the article

Corresponding author: Prof. Artur Bossowski, MD, PhD – ETA, ESE, ESC, ESPE member, Department of Pediatrics, Endocrinology and Diabetes with a Cardiology Unit, Medical University of Białystok, ul. Waszyngtona 17, Białystok 15-274, Poland, Phone: +857450-735, Fax:  +(085)7450730

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Received: 2018-08-19

Accepted: 2019-02-08

Published Online: 2019-03-23

Published in Print: 2019-04-24

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Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: Shu Chen, Sarah Black, Michael Powell, Jadwiga Furmaniak and Bernard Rees Smith are employees of RSR Ltd. RSR Ltd. is a developer of medical diagnostics including kits for measuring autoantibodies.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 32, Issue 4, Pages 355–361, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2018-0367.

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