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Islet, thyroid and transglutaminase antibodies in adult Bulgarian patients with type 1 diabetes

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Abstract

Aim

The aim of the study was to assess the prevalence and relationship of islet antibodies and autoantibodies of the most common associated autoimmune diseases—autoimmune thyroid disease (AITD) and celiac disease, in adult Bulgarian patients with type 1 diabetes of short duration.

Material and methods

160 type 1 diabetes patients, of mean age 36.3 ± 10.9 years, mean BMI 23.0 ± 4.2 kg/m2 and mean disease duration 1.35 ± 1.69 years were enrolled. Pancreatic islet cell antibodies—glutamic acid decarboxylase antibodies (GAD 65-Ab), tyrosine phosphatase antibodies (IA 2-Ab), and zinc transporter 8 antibodies (ZnT8-Ab), thyroid antibodies—thyroperoxidase and thyroglobulin antibodies, and transglutaminase antibodies (TTG-IgA-Ab) were assessed by ELISA.

Results

87.5% of the patients had one or more of the islet antibodies—78.1% had GAD 65-Ab, 53.1%—ZnT8-Ab, and 34.4%—IA 2-Ab. 5% presented as just ZnT8-Ab positive. GAD 65-Ab identified 90.6% of the antibody positive patients. The addition of IA 2-Ab as a second immunologic marker identified 94.4%, while the use of ZnT8-Ab in second place identified 98.8% of the cases. 24.4% presented with positive thyroid antibodies and 33.8% had AITD. No relation was found between any of the islet antibodies and AITD. None of the patients was TTG-IgA-Ab positive. No significant correlations were established between the antibodies with different organ specificity.

Conclusions

In adult Bulgarian type 1 diabetes patients ZnT8-Ab is an independent diagnostic marker rating second in prevalence and diagnostic significance after GAD 65-Ab. AITD affects about one third of this population and routine screening is required, while screening for celiac disease is not justified.

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Acknowledgements

The authors would like to thank all of the study participants and the team of the Division of Diabetology, Department of Endocrinology, Medical University Sofia.

Funding

The study is fully funded by Medical University Sofia, Grant No. D-113/2018.

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Authors and Affiliations

  1. Department of Endocrinology, Division of Diabetology, Medical University Sofia, Sofia, Bulgaria

    Nevena Chakarova, Rumyana Dimova, Mina Serdarova, Greta Grozeva & Tsvetalina Tankova

  2. Med Dia Laboratory, Sofia, Bulgaria

    Maria Kuncheva & Lubomir Kamenov

Authors
  1. Nevena Chakarova
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  2. Rumyana Dimova
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  3. Mina Serdarova
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Correspondence to Nevena Chakarova.

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Chakarova, N., Dimova, R., Serdarova, M. et al. Islet, thyroid and transglutaminase antibodies in adult Bulgarian patients with type 1 diabetes. Endocrine 70, 299–306 (2020). https://doi.org/10.1007/s12020-020-02395-1

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  • DOI: https://doi.org/10.1007/s12020-020-02395-1

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