Beta-cell, thyroid, gastric, adrenal and coeliac autoimmunity and HLA-DQ types in type 1 diabetes.

Abstract

The autoimmune attack in type 1 diabetes is not only targeted to beta cells. We assessed the prevalence of thyroid peroxidase (aTPO), parietal cell (PCA), antiadrenal (AAA) and endomysial antibodies (EmA-IgA), and of overt autoimmune disease in type 1 diabetes, in relation to gender, age, duration of disease, age at onset, beta-cell antibody status (ICA, GADA, IA2A) and HLA-DQ type. Sera from 399 type 1 diabetic patients (M/F: 188/211; mean age: 26 +/- 16 years; duration: 9 +/- 8 years) were tested for ICA, PCA, AAA and EmA-IgA by indirect immunofluorescence, and for IA2A (tyrosine phosphatase antibodies), GADA (glutamic acid decarboxylase-65 antibodies) and aTPO by radiobinding assays. The prevalence rates were: GADA 70%; IA2A, 44%; ICA, 39%; aTPO, 22%; PCA, 18%; EmA-IgA, 2%; and AAA, 1%. aTPO status was determined by female gender (beta = - 1.15, P = 0.002), age (beta = 0.02, P = 0.01) and GADA + (beta = 1.06, P = 0.02), but not by HLA-DQ type or IA2A status. Dysthyroidism (P < 0.0001) was more frequent in aTPO + subjects. PCA status was determined by age (beta = 0.03, P = 0.002). We also observed an association between PCA + and GADA + (OR = 1.9, P = 0.049), aTPO + (OR = 1.9, P = 0.04) and HLA DQA1*0501-DQB1*0301 status (OR = 2.4, P = 0.045). Iron deficiency anaemia (OR = 3.0, P = 0.003) and pernicious anaemia (OR = 40, P < 0.0001) were more frequent in PCA + subjects. EmA-IgA + was linked to HLA DQA1*0501-DQB1*0201 + (OR = 7.5, P = 0.039), and coeliac disease was found in three patients. No patient had Addison's disease. In conclusion, GADA but not IA2A indicate the presence of thyrogastric autoimmunity in type 1 diabetes. aTPO have a female preponderance, PCA are weakly associated with HLA DQA1*0501-DQB1*0301 and EmA-IgA + with HLA DQA1*0501-DQB1*0201.

• Authors: C E De Block, I H De Leeuw, J J Vertommen, R P Rooman, M V Du Caju, C M Van Campenhout, J J Weyler, F Winnock, J Van Autreve, F K Gorus, Belgian Diabetes Registry
• Journal: Clinical and experimental immunology (Clin Exp Immunol) Vol. 126 Issue 2 Pg. 236-41 (Nov 2001) ISSN: 0009-9104 [Print] England
• PMID: 11703366 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• HLA-DQ Antigens
• islet cell antibody
• Iodide Peroxidase
• Glutamate Decarboxylase

Topics

• Adolescent
• Adrenal Glands (immunology)
• Adult
• Autoantibodies (blood)
• Autoimmunity
• Celiac Disease (immunology)
• Child
• Diabetes Mellitus, Type 1 (genetics, immunology)
• Female
• Genetic Linkage
• Glutamate Decarboxylase (immunology)
• HLA-DQ Antigens (genetics)
• Humans
• Iodide Peroxidase (immunology)
• Male
• Organ Specificity
• Parietal Cells, Gastric (immunology)