Organ-specific antibodies in LADA patients for the prediction of insulin dependence. (2nd July 2016)

• Record Type: Journal Article
• Authors: Delitala, Alessandro P.; Pes, Giovanni M.; Fanciulli, Giuseppe; Maioli, Margherita; Secchi, Giannina; Sanciu, Franca; Delitala, Giuseppe; Manetti, Roberto
• Is Part Of: Endocrine research. Volume 41:Number 3(2016:Aug.)
• Page Start: 207
• Page End: 212
• Publication Date: 2016-07-02
• Subjects: APCA -- LADA -- organ specific autoantibodies -- TPOAb -- ZnT8Ab; Endocrinology, Experimental -- Periodicals; Endocrinology -- Periodicals; Endocrinology -- Periodicals; Research -- Periodicals; 616.4
• DOI: 10.3109/07435800.2015.1136934
• Languages: English
• ISSNs: 0743-5800

Abstract

ABSTRACT: Aim of the study: 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.Materials and 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.