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Long-term sustained autoimmune response to beta cell specific zinc transporter (ZnT8, W, R, Q) in young adult patients with preserved beta cell function at diagnosis of diabetes
Lund University.
Lund University.ORCID iD: 0000-0002-9953-2829
University of Gothenburg.
The Nordic Research Academy for Global Health.
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2013 (English)In: Autoimmunity, ISSN 0891-6934, E-ISSN 1607-842X, Vol. 46, no 1, 50-61 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to examine whether autoantibodies to: ZnT8-Tryptophan (ZnT8WA), ZnT8-Arginine (ZnT8RA) or ZnT8-Glutamine (ZnT8QA) correlated with C-peptide or other autoantibodies and to assess diagnostic sensitivity of ZnT8WRQA. Specimens from 270 newly diagnosed diabetic subjects (age 15-34 years) and after 5 years duration of disease were examined. Four linear regression models were used to dissect the importance of different factors from diagnosis for the respective difference of (logZnT8WA), (logZnT8RA) and (logZnT8QA); A) unadjusted model for: initial C-peptide, age, BMI, gender, clinical classification, ICA, GADA, IA-2A, (ZnT8WA/ZnT8RA/ZnT8QA); B) C-peptide corrected for clinical factors; C) C-peptide corrected for autoantibodies; D) C-peptide corrected for all factors. The least decrease of ZnT8WA was observed in patients with high initial C-peptide in all models A) p = 0.054; B) p = 0.021; C) p = 0.047 and D) p = 0.017. A less statistically significant decrease of ZnT8RA was observed in patients with high initial C-peptide in A) p = 0.038 and C) p = 0.047, but this finding was not confirmed in B or D. The decrease of ZnT8QA levels was not related to C-peptide in any model but correlated to age D) p = 0.049. Furthermore, patients with unclassifiable diabetes showed the least decrease in D) p = 0.035. ZnT8WA, ZnT8RA or ZnT8QA were identified as a single autoantibody in 3.8% (10/266) of patients, thereby increasing diagnostic sensitivity from 79.3% (211/266) to 83.1% (221/266). In conclusion, high initial C-peptide was the most important factor even after adjusting for other factors in patients positive for ZnT8WA or ZnT8RA to remain autoantibody positive 5 years after diagnosis.

Place, publisher, year, edition, pages
2013. Vol. 46, no 1, 50-61 p.
Keyword [en]
C-peptide, Generalized Linear Regression Model, glutamic acid decarboxylase autoantibodies, islet antigen-2 autoantibodies, islet cell antibodies
National Category
Cell and Molecular Biology Immunology in the medical area
Identifiers
URN: urn:nbn:se:hkr:diva-12680DOI: 10.3109/08916934.2012.730585ISI: 000313589000008PubMedID: 23039265OAI: oai:DiVA.org:hkr-12680DiVA: diva2:739634
Available from: 2014-08-21 Created: 2014-08-21 Last updated: 2017-01-11Bibliographically approved

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