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A quarter of patients with type 1 diabetes have co-existing non-islet autoimmunity: the findings of a UK population-based family study.
Clin Exp Immunol 2018; 192(3):251-258CE

Abstract

Individuals with type 1 diabetes (T1D) are at increased risk of coeliac disease (CD), autoimmune thyroiditis and autoimmune gastritis, but the absolute risks are unclear. The aim of this study was to investigate the prevalence of autoantibodies to tissue transglutaminase (TGA), thyroid peroxidase (TPOA) and gastric H+ /K+ -ATPase (ATPA) and their genetic associations in a well-characterized population-based cohort of individuals with T1D from the Bart's-Oxford family study for whom islet autoantibody prevalence data were already available. Autoantibodies in sera from 1072 patients (males/females 604/468; median age 11·8 years, median T1D duration 2·7 months) were measured by radioimmunoassays; HLA class II risk genotype was analysed in 973 (91%) using polymerase chain reaction with sequence specific primers (PCR-SSP). The prevalence of TGA (and/or history of CD), TPOA and ATPA in patients was 9·0, 9·6 and 8·2%, respectively; 3·1% had two or more autoantibodies. Females were at higher risk of multiple autoimmunity; TGA/CD were associated with younger age and TPOA with older age. ATPA were uncommon in patients under 5 years, and more common in older patients. Anti-glutamate decarboxylase autoantibodies were predictive of co-existing TPOA/ATPA. TGA/CD were associated with human leucocyte antigen (HLA) DR3-DQ2, with the DR3-DQ2/DR3-DQ2 genotype conferring the highest risk, followed by DR4-DQ8/DR4-DQ8. ATPA were associated with DR3-DQ2, DRB1*0404 (in males) and the DR3-DQ2/DR4-DQ8 genotype. TPOA were associated with the DR3-DQ2/DR3-DQ2 genotype. Almost one-quarter of patients diagnosed with T1D aged under 21 years have at least one other organ-specific autoantibody. HLA class II genetic profiling may be useful in identifying those at risk of multiple autoimmunity.

Authors+Show Affiliations

Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.The Barbara Davis Center for Diabetes, University of Colorado, Denver, CO, USA.The Barbara Davis Center for Diabetes, University of Colorado, Denver, CO, USA.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.Diabetes and Metabolism, Translational Health Sciences, University of Bristol, Bristol, UK.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29431870

Citation

Kozhakhmetova, A, et al. "A Quarter of Patients With Type 1 Diabetes Have Co-existing Non-islet Autoimmunity: the Findings of a UK Population-based Family Study." Clinical and Experimental Immunology, vol. 192, no. 3, 2018, pp. 251-258.
Kozhakhmetova A, Wyatt RC, Caygill C, et al. A quarter of patients with type 1 diabetes have co-existing non-islet autoimmunity: the findings of a UK population-based family study. Clin Exp Immunol. 2018;192(3):251-258.
Kozhakhmetova, A., Wyatt, R. C., Caygill, C., Williams, C., Long, A. E., Chandler, K., ... Williams, A. J. K. (2018). A quarter of patients with type 1 diabetes have co-existing non-islet autoimmunity: the findings of a UK population-based family study. Clinical and Experimental Immunology, 192(3), pp. 251-258. doi:10.1111/cei.13115.
Kozhakhmetova A, et al. A Quarter of Patients With Type 1 Diabetes Have Co-existing Non-islet Autoimmunity: the Findings of a UK Population-based Family Study. Clin Exp Immunol. 2018;192(3):251-258. PubMed PMID: 29431870.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A quarter of patients with type 1 diabetes have co-existing non-islet autoimmunity: the findings of a UK population-based family study. AU - Kozhakhmetova,A, AU - Wyatt,R C, AU - Caygill,C, AU - Williams,C, AU - Long,A E, AU - Chandler,K, AU - Aitken,R J, AU - Wenzlau,J M, AU - Davidson,H W, AU - Gillespie,K M, AU - Williams,A J K, Y1 - 2018/03/24/ PY - 2018/02/05/accepted PY - 2018/2/13/pubmed PY - 2019/6/27/medline PY - 2018/2/13/entrez KW - HLA KW - gastric H+/K+-ATPase antibodies KW - thyroid peroxidase antibodies KW - tissue transglutaminase antibodies KW - type 1 diabetes SP - 251 EP - 258 JF - Clinical and experimental immunology JO - Clin. Exp. Immunol. VL - 192 IS - 3 N2 - Individuals with type 1 diabetes (T1D) are at increased risk of coeliac disease (CD), autoimmune thyroiditis and autoimmune gastritis, but the absolute risks are unclear. The aim of this study was to investigate the prevalence of autoantibodies to tissue transglutaminase (TGA), thyroid peroxidase (TPOA) and gastric H+ /K+ -ATPase (ATPA) and their genetic associations in a well-characterized population-based cohort of individuals with T1D from the Bart's-Oxford family study for whom islet autoantibody prevalence data were already available. Autoantibodies in sera from 1072 patients (males/females 604/468; median age 11·8 years, median T1D duration 2·7 months) were measured by radioimmunoassays; HLA class II risk genotype was analysed in 973 (91%) using polymerase chain reaction with sequence specific primers (PCR-SSP). The prevalence of TGA (and/or history of CD), TPOA and ATPA in patients was 9·0, 9·6 and 8·2%, respectively; 3·1% had two or more autoantibodies. Females were at higher risk of multiple autoimmunity; TGA/CD were associated with younger age and TPOA with older age. ATPA were uncommon in patients under 5 years, and more common in older patients. Anti-glutamate decarboxylase autoantibodies were predictive of co-existing TPOA/ATPA. TGA/CD were associated with human leucocyte antigen (HLA) DR3-DQ2, with the DR3-DQ2/DR3-DQ2 genotype conferring the highest risk, followed by DR4-DQ8/DR4-DQ8. ATPA were associated with DR3-DQ2, DRB1*0404 (in males) and the DR3-DQ2/DR4-DQ8 genotype. TPOA were associated with the DR3-DQ2/DR3-DQ2 genotype. Almost one-quarter of patients diagnosed with T1D aged under 21 years have at least one other organ-specific autoantibody. HLA class II genetic profiling may be useful in identifying those at risk of multiple autoimmunity. SN - 1365-2249 UR - https://www.unboundmedicine.com/medline/citation/29431870/A_quarter_of_patients_with_type_1_diabetes_have_co_existing_non_islet_autoimmunity:_the_findings_of_a_UK_population_based_family_study_ L2 - https://doi.org/10.1111/cei.13115 DB - PRIME DP - Unbound Medicine ER -