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Can islets autoantibody profile at diagnosis of Type 1 Diabetes in children and adolescents predict the future development of Hashimoto’s thyroiditis and coeliac disease?

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Shee, A, Prior, S ORCID: 0000-0001-5782-9141 and Reeves, N 2020 , 'Can islets autoantibody profile at diagnosis of Type 1 Diabetes in children and adolescents predict the future development of Hashimoto’s thyroiditis and coeliac disease?' , Journal of Pediatric Endocrinology, vol. 5, no. 1 , pp. 1-5 .

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Abstract

Aim: This study aims to explore if any correlation exists between isletsautoantibody profile at diagnosis in children and adolescents with type 1diabetes and subsequent development of Hashimoto’s thyroiditis and coeliacdisease.Materials and Methods: In this multicentre retrospective cohort studyconducted in three hospitals, for children below 18 years of age diagnosedwith Type 1 Diabetes (T1D) over a ten-year period between 1 January 2009and 31 December 2018, electronic Medical Records (DMR) were looked at andanalysed by using SPSS V24.0, for several data variables such as antibodyprofile (type and number of three antibodies-GAD, IAA and ZnTr8 present andtheir titres), demographical characteristics (BMI, gender, age of onset), severityof disease at presentation (DKA vs non-DKA and HbA1c value) and subsequentdevelopment of Hashimoto’s Thyroiditis (HT) and Coeliac Disease (CD).Results: Out of 218 children (male = 112, female = 103) tested during thisstudy period, IAA was the most prevalent antibody found which was positive in90 (41%) cases followed by GAD in 83(38%) and ZnTr8 in 34 (16%) children.Median age of onset of T1D was 7.709 years (range 1-17 years) and themean HbA1c at presentation was 8.8% (range 5.5% - 14.6%). HT and CDwere identified in 31 (12.8%) and 14 (5.8%) cases respectively in this cohort.Independent samples t-tests could not identify any significant difference in theGAD, IAA and ZnTr8 antibody levels for the children with or without HT{(M =148.16, SD = 507.9) and (M = 117.6, SD = 402.2); t (103) = 0.275, p = 0.784 inGAD}, {(M = 514.46, SD = 1360.7) and (M = 316.86, SD = 972.02); t (99) = 0.697,p = 0.487) in IAA}, {(M = 309.63, SD = 397.76) and (M = 383.26, SD = 462.70) ; t(32) = 0.385, p = 0.703) in ZnTr8}. Likewise, there has not been any statisticallysignificant difference for those with or without CD {(M = 57.9, SD = 107.5) and(M = 91.21, SD = 326.4); t (93) = 0.335, p = 0.739 in GAD}, {(M = 22.41, SD =18.0) and (M = 420.87, SD = 1140.2); t (90) = 1.10, p = 0.274 in IAA}. One-wayANOVA {F (2) = .970, p = 0.382} could not identify any correlation betweenthe number of antibodies present at diagnosis and subsequent developmentof HT. There was, however, a statistically significant difference recognised, asdetermined by a one-way ANOVA {F (2,112) = 3.305, p = Conclusion: IAA was the most prevalent islets autoantibody found in thisstudy, followed by GAD and ZnTr8. All three antibodies were positive in 13%cases. Although, GAD, IAA and ZnTr8 antibody titres at diagnosis are notpredictive of subsequent development of HT and CD, the number of antibodiespresent influences the future risk of CD but not for HT. Presence of all the threeantibodies nearly quadruples the possibility of subsequent development of CD.As HLA typing is not a predictor of development of CD in children with T1D, thisfinding can influence the frequency of serology testing.

Item Type: Article
Authors/Creators:Shee, A and Prior, S and Reeves, N
Keywords: T1D, Type 1 Diabetes mellitus, IAs, islets autoantibodies, GADA, glutamic acid decarboxylase antibody, IAA, insulin autoantibody, IA2A, insulinoma antigen-2 antibody, ZnTr8A, zinc transporter 8 antibody, HT, Hashimoto’s thyroiditis, CD, coeliac dise
Journal or Publication Title: Journal of Pediatric Endocrinology
Publisher: Austin Publishing Group
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