Gastric parietal cell antibodies are associated with glutamic acid decarboxylase-65 antibodies and the HLA DQA1*0501-DQB1*0301 haplotype in Type 1 diabetes mellitus. Belgian Diabetes Registry.
OBJECTIVE
To assess the prevalence of thyrogastric autoimmunity in relation to age, sex, beta-cell antibody status and HLA DQ haplotypes in Type 1 diabetes mellitus.


METHODS
One hundred and seventy-one patients with Type 1 diabetes mellitus were studied (male/female 86/85; mean age 19 +/- 11 years; duration of diabetes 5 +/- 4 years). Islet cell antibodies (ICA) and parietal cell antibodies (PCA) were measured using indirect immunofluorescence; glutamic acid decarboxylase-65 antibodies (GADA) by radiobinding assay and thyroid peroxidase antibodies (TPO) with an immunoradiometric assay (IRMA).


RESULTS
The majority of subjects (81.3%) showed one or more autoantibodies. The prevalence rates were: GADA 64.9%, ICA 46.2%, PCA 19.9% and TPO 19.3%. Patients with ICA+ > or = 3 years after diagnosis had a higher prevalence of GADA (P = 0.03, odds ratio (OR) 2.66) and thyrogastric antibodies (P = 0.05, OR 2.23) than subjects ICA- after 3 years. PCA+ patients were older (P = 0.04), had a higher prevalence of GADA (P = 0.005, OR 3.89) and TPO (P = 0.05, OR 2.50) than PCA- subjects. Logistic regression analysis showed that PCA status was determined by the HLA DQA1*0501-DQB1*0301 haplotype (beta = 2.94, P = 0.04) and GADA status (beta = 2.44, P = 0.041).


CONCLUSIONS
Thyrogastric antibodies are highly prevalent in Type 1 diabetes mellitus, especially in patients with persisting ICA. Screening for gastric autoimmunity is particularly advised in patients who are positive for GADA and for the HLA DQA1*0501-DQB1*0301 haplotype.
De Block
C E
CE
Department of Endocrinology-Diabetology, University Hospital Antwerp, Edegem, Belgium. cdeblock@uia.ua.ac.be
De Leeuw
I H
IH
Rooman
R P
RP
Winnock
F
F
Du Caju
M V
MV
Van Gaal
L F
LF
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000276:immunology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006683:HLA-DQ Antigens / Q000235:genetics*; D059848:HLA-DQ alpha-Chains; D059866:HLA-DQ beta-Chains; D006239:Haplotypes; D006801:Humans; D015592:Immunoradiometric Assay; D007453:Iodide Peroxidase / Q000276:immunology*; D007515:Islets of Langerhans / Q000276:immunology; D007527:Isoenzymes / Q000276:immunology*; D008297:Male; D010295:Parietal Cells, Gastric / Q000276:immunology*; D012044:Regression Analysis; D012737:Sex Factors
D001323:Autoantibodies; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin; D006683:HLA-DQ Antigens; D059848:HLA-DQ alpha-Chains; D059866:HLA-DQ beta-Chains; D007453:Iodide Peroxidase; D007527:Isoenzymes; C069050:HLA-DQA1 antigen; C069051:HLA-DQB1 antigen; C024211:islet cell antibody; C401141:glutamate decarboxylase 2