Islet cell, thyroid, adrenal and celiac disease related autoantibodies in patients with Type 1 diabetes from Sri Lanka.
OBJECTIVE
The prevalence of islet cell, thyroid, adrenal and celiac disease related autoantibodies in patients with Type 1 diabetes mellitus (Type 1 DM) from Sri Lanka is described.


METHODS
Autoantibodies to glutamic acid decarboxylase 65 (GAD65Ab), protein tyrosine phosphatase IA-2 (IA-2Ab), insulin (IAAb), thyroglobulin (TgAb), thyroid peroxidase (TPOAb), TSH receptor (TRAb), 21-hydroxylase (21-OHAb) and tissue transglutaminase (tTGAb) were measured in 122 Type 1 DM patients who had low C-peptide activity or were >20 yr old at the time of diagnosis and in 100 non-diabetic blood donors.


RESULTS
GAD65Ab and/or IA-2Ab were present in 74/122 (60.7%) Type 1 DM subjects with a significantly higher prevalence compared to non-diabetic controls (no. 100) (GAD65Ab-59 vs 4%; IA-2Ab-14 vs 0%; respectively) (p<0.001). The median (inter-quartile range) Type 1 DM duration in antibody positive subjects was 3.3 (0.99-6.9) vs 4.9 (1.7-7.5) yr in antibody negative subjects (p=0.23). IA-2Ab prevalence decreased with disease duration > or =5 yr (19 vs 4%) (p<0.001). There was no difference in the prevalence of TgAb (25 vs 33%)(p=0.21) and TPOAb (22 vs 18%) (p=0.48) in Type 1 DM and non-diabetic subjects. Also, there was no difference in TgAb and TPOAb prevalence in antibody positive Type 1 DM (34.7%) compared to antibody negative Type 1 DM (24.4%) subjects (p=0.24). tTGAb (3/119) and TRAb (1/119) were found in low prevalence and 21-OHAb were not detected.


CONCLUSIONS
Diabetes associated autoantibodies were detected in the majority of Type 1 DM subjects, suggesting a major role for autoimmunity in the pathogenesis of Type 1 DM in Sri Lankans. The prevalence of TgAb and TPOAb in Type 1 DM subjects and non-diabetic controls was relatively high and similar in both groups.
Premawardhana
L D K E
LD
Department of Medicine, Caerphilly Miners' Hospital, Caerphilly, UK. Ldke.Premawardhana@gwent.wales.nhs.uk
Wijeyaratne
C N
CN
Chen
S
S
Wijesuriya
M
M
Illangasekera
U
U
Brooking
H
H
Amoroso
M
M
Jeffreys
J
J
Bolton
J
J
Lazarus
J H
JH
Furmaniak
J
J
Rees Smith
B
B
D000293:Adolescent; D000311:Adrenal Glands / Q000276:immunology*; D000328:Adult; D017668:Age of Onset; D001323:Autoantibodies / Q000032:analysis*; D002446:Celiac Disease / Q000453:epidemiology / Q000276:immunology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000276:immunology*; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006801:Humans; D018828:Immunoglobulins, Thyroid-Stimulating; D007330:Insulin Antibodies / Q000032:analysis; D007453:Iodide Peroxidase / Q000276:immunology; D007515:Islets of Langerhans / Q000276:immunology*; D007527:Isoenzymes / Q000276:immunology; D008297:Male; D015995:Prevalence; D054562:Protein Tyrosine Phosphatase, Non-Receptor Type 1; D017027:Protein Tyrosine Phosphatases / Q000276:immunology; D013188:Sri Lanka / Q000453:epidemiology; D013255:Steroid 21-Hydroxylase / Q000276:immunology; D013961:Thyroid Gland / Q000276:immunology*; D011503:Transglutaminases / Q000276:immunology
D001323:Autoantibodies; D018828:Immunoglobulins, Thyroid-Stimulating; D007330:Insulin Antibodies; D007527:Isoenzymes; C094372:thyrotropin-binding inhibitory immunoglobulin; D007453:Iodide Peroxidase; D013255:Steroid 21-Hydroxylase; D011503:Transglutaminases; D054562:Protein Tyrosine Phosphatase, Non-Receptor Type 1; D017027:Protein Tyrosine Phosphatases; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2