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Prevalence of β-cell antibodies and associated autoimmune diseases in children and adolescents with type 1 diabetes (T1DM) versus type 2 diabetes (T2DM) in Qatar.
Acta Biomed. 2018 05 23; 89(S5):32-39.AB

Abstract

INTRODUCTION

Type 1 diabetes mellitus (T1DM) is an autoimmune disease with the development of abnormal immune responses to specific β-cell autoantigens in addition to other organ-specific autoimmunity. The most frequent associated disorders are thyroid dysfunctions and celiac disease. There are limited studies in the current literature on the prevalence of associated autoimmunity, especially multiple, in children and adolescents with T1DM and Type 2 diabetes mellitus (T2DM).

OBJECTIVES

The aim of the present study was to determine the prevalence of autoantibodies and thyroid dysfunctions in a cohort of children and adolescents (aged 0.5-16 years) with T1DM living in Qatar.

RESEARCH DESIGN AND METHODS

The records of all children and adolescents attending the Pediatric Diabetes Center of Hamad Medical Center, for the past 5 years (from January 2012 to December 2016), were reviewed and all clinical and biochemical data, including β-cell autoimmunity [anti-glutamic acid decarboxylase (GAD) antibodies, anti-islet cell and anti-insulin antibodies (IAA)], thyroid function (Free thyroxine: FT4 and thyroid-stimulating hormone: TSH), anti-thyroid peroxidase antibodies (TPO) and anti-tissue transglutaminase (ATT) were collected at their first presentation (cross-sectional study). Data for patients with T1DM (n=431) and T2DM (n=59) were recorded analyzed and the prevalence calculated and compared with other studies.

RESULTS

The prevalence of anti-GAD antibodies was 75.5 % in T1DM and 29.3% in T2DM. Anti β-islet antibodies (Ab) were detected in 53.4% of T1DM and 29.4% of T2DM. Anti-insulin Ab were detected in 40.4% of T1DM and 58.3% of T2DM. The three antibodies together were detected in 18.4 % of T1DM and none of T2DM. At presentation, hypothyroidism (FT4 <11.5 pmol/L) was detected in 10.6% of T1DM and 10% of T2DM. Subclinical hypothyroidism was diagnosed in 3.5% of T1DM and 8% of T2DM. High anti TPO was detected in 27.2% of T1DM and 34.6% of T2DM. High TPO with normal thyroid function were found in 22.7% of T1DM and 23.1% of T2DM. ATT IgA was high in 5% of T1DM and 8.7% of T2DM whereas ATT IgG was high in 4.4 % of T1DM and not detected in any patient with T2DM. Mucosal biopsy proved celiac disease in 9 out of 12 patients (75%) with positive ATT IgA and IgG antibodies.

CONCLUSIONS

Qatar has a relatively high incidence of T1DM compared to incidences reported worldwide. The incidence increased over the period 2012-2015. We report a high prevalence of associated autoimmune abnormalities in our patients with T1DM and T2DM. These data strengthen the argument for routine screening of all children and adolescents with T1DM and T2DM for other autoimmune disorders, particularly the thyroid gland.

Authors+Show Affiliations

Department of Pediatrics, Hamad Medical Center, Doha, Qatar. atsoliman@yahoo.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30049930

Citation

Alyafei, Fawzia, et al. "Prevalence of Β-cell Antibodies and Associated Autoimmune Diseases in Children and Adolescents With Type 1 Diabetes (T1DM) Versus Type 2 Diabetes (T2DM) in Qatar." Acta Bio-medica : Atenei Parmensis, vol. 89, no. S5, 2018, pp. 32-39.
Alyafei F, Soliman A, Alkhalaf F, et al. Prevalence of β-cell antibodies and associated autoimmune diseases in children and adolescents with type 1 diabetes (T1DM) versus type 2 diabetes (T2DM) in Qatar. Acta Biomed. 2018;89(S5):32-39.
Alyafei, F., Soliman, A., Alkhalaf, F., Sabt, A., De Sanctis, V., Elsayed, N., & Waseef, R. (2018). Prevalence of β-cell antibodies and associated autoimmune diseases in children and adolescents with type 1 diabetes (T1DM) versus type 2 diabetes (T2DM) in Qatar. Acta Bio-medica : Atenei Parmensis, 89(S5), 32-39. https://doi.org/10.23750/abm.v89iS4.7359
Alyafei F, et al. Prevalence of Β-cell Antibodies and Associated Autoimmune Diseases in Children and Adolescents With Type 1 Diabetes (T1DM) Versus Type 2 Diabetes (T2DM) in Qatar. Acta Biomed. 2018 05 23;89(S5):32-39. PubMed PMID: 30049930.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of β-cell antibodies and associated autoimmune diseases in children and adolescents with type 1 diabetes (T1DM) versus type 2 diabetes (T2DM) in Qatar. AU - Alyafei,Fawzia, AU - Soliman,Ashraf, AU - Alkhalaf,Fawziya, AU - Sabt,Aml, AU - De Sanctis,Vincenzo, AU - Elsayed,Nagwa, AU - Waseef,Reem, Y1 - 2018/05/23/ PY - 2018/05/23/received PY - 2018/7/28/entrez PY - 2018/7/28/pubmed PY - 2019/11/21/medline SP - 32 EP - 39 JF - Acta bio-medica : Atenei Parmensis JO - Acta Biomed VL - 89 IS - S5 N2 - INTRODUCTION: Type 1 diabetes mellitus (T1DM) is an autoimmune disease with the development of abnormal immune responses to specific β-cell autoantigens in addition to other organ-specific autoimmunity. The most frequent associated disorders are thyroid dysfunctions and celiac disease. There are limited studies in the current literature on the prevalence of associated autoimmunity, especially multiple, in children and adolescents with T1DM and Type 2 diabetes mellitus (T2DM). OBJECTIVES: The aim of the present study was to determine the prevalence of autoantibodies and thyroid dysfunctions in a cohort of children and adolescents (aged 0.5-16 years) with T1DM living in Qatar. RESEARCH DESIGN AND METHODS: The records of all children and adolescents attending the Pediatric Diabetes Center of Hamad Medical Center, for the past 5 years (from January 2012 to December 2016), were reviewed and all clinical and biochemical data, including β-cell autoimmunity [anti-glutamic acid decarboxylase (GAD) antibodies, anti-islet cell and anti-insulin antibodies (IAA)], thyroid function (Free thyroxine: FT4 and thyroid-stimulating hormone: TSH), anti-thyroid peroxidase antibodies (TPO) and anti-tissue transglutaminase (ATT) were collected at their first presentation (cross-sectional study). Data for patients with T1DM (n=431) and T2DM (n=59) were recorded analyzed and the prevalence calculated and compared with other studies. RESULTS: The prevalence of anti-GAD antibodies was 75.5 % in T1DM and 29.3% in T2DM. Anti β-islet antibodies (Ab) were detected in 53.4% of T1DM and 29.4% of T2DM. Anti-insulin Ab were detected in 40.4% of T1DM and 58.3% of T2DM. The three antibodies together were detected in 18.4 % of T1DM and none of T2DM. At presentation, hypothyroidism (FT4 <11.5 pmol/L) was detected in 10.6% of T1DM and 10% of T2DM. Subclinical hypothyroidism was diagnosed in 3.5% of T1DM and 8% of T2DM. High anti TPO was detected in 27.2% of T1DM and 34.6% of T2DM. High TPO with normal thyroid function were found in 22.7% of T1DM and 23.1% of T2DM. ATT IgA was high in 5% of T1DM and 8.7% of T2DM whereas ATT IgG was high in 4.4 % of T1DM and not detected in any patient with T2DM. Mucosal biopsy proved celiac disease in 9 out of 12 patients (75%) with positive ATT IgA and IgG antibodies. CONCLUSIONS: Qatar has a relatively high incidence of T1DM compared to incidences reported worldwide. The incidence increased over the period 2012-2015. We report a high prevalence of associated autoimmune abnormalities in our patients with T1DM and T2DM. These data strengthen the argument for routine screening of all children and adolescents with T1DM and T2DM for other autoimmune disorders, particularly the thyroid gland. SN - 2531-6745 UR - https://www.unboundmedicine.com/medline/citation/30049930/Prevalence_of_β_cell_antibodies_and_associated_autoimmune_diseases_in_children_and_adolescents_with_type_1_diabetes__T1DM__versus_type_2_diabetes__T2DM__in_Qatar_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30049930/ DB - PRIME DP - Unbound Medicine ER -