title: Organ-specific antibodies in LADA patients for the prediction of insulin dependence.
abstract: OBJECTIVE
  The aim of the present study was to define the frequency of organ-specific and non-organ-specific autoantibodies in a cohort of Latent Autoimmune Diabetes in Adults (LADA) patients and to test whether multiple antibodies positivity could be a predictor of early insulin dependence.
  
  
  METHODS
  We enrolled 210 LADA and 210 type 2 diabetes mellitus (T2D) patients. In all subjects anti-islet antigen-2 (IA-2Ab), anti-thyroperoxidase (TPOAb), anti-zinc transporter 8 (ZnT8Ab), anti-nuclear (ANA), anti-parietal cell (APCA), anti-smooth muscle (ASMA), anti-mitochondrial (AMA), anti-liver kidney microsomes (LKM), and anti-reticulin (ARA) circulating antibodies were assessed.
  
  
  RESULTS
  The frequency of TPOAb, ZnT8Ab, APCA, and IA-2Ab positivity was, respectively, detected in 40.0%, 32.4%, 24.7%, and 9.5% of LADA patients, whereas their frequency was significantly lower in T2D patients (11.4%, 1.9%, 9.5%, and 0.0%, respectively, p < 0.001). The frequency of ANA was the same in both groups whereas the frequency of ASMA, ARA, AMA, and LKM was very low (range 0.0-3.3%). The presence of TPOAb associated with ZnT8Ab, IA-2Ab, or APCA allows one to predict the progression of disease with a high specificity but low sensibility.
  
  
  CONCLUSIONS
  LADA patients show an increased frequency of organ- and non-organ-specific antibodies. Consequently, a screening is worthwhile in these patients. The simultaneous presence of TPOAb with ZnT8, IA-2Ab, or APCA may help differentiate clinical phenotypes and predict faster insulin dependence in LADA patients.
authors: a Internal Medicine Unit, Azienda Ospedaliero-Universitaria di Sassari , Sassari , Italy.
authors: Alessandro P
authors: AP
authors: Delitala
authors: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors: Giovanni M
authors: GM
authors: Pes
authors: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors: Giuseppe
authors: G
authors: Fanciulli
authors: c Department of Biomedical Science , University of Sassari , Sassari , Italy.
authors: Margherita
authors: M
authors: Maioli
authors: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors: Giannina
authors: G
authors: Secchi
authors: a Internal Medicine Unit, Azienda Ospedaliero-Universitaria di Sassari , Sassari , Italy.
authors: Franca
authors: F
authors: Sanciu
authors: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors: Giuseppe
authors: G
authors: Delitala
authors: b Department of Clinical and Experimental Medicine , University of Sassari , Sassari , Italy.
authors: Roberto
authors: R
authors: Manetti
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D000071698:Latent Autoimmune Diabetes in Adults / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies
keywords: APCA; LADA; TPOAb; ZnT8Ab; organ specific autoantibodies