Endocrine Abstracts

Objective: The presence of APA has been reported in patients with autoimmune polyendocrinopathies, but their prevalence in type 1 diabetes mellitus (T1D) is still unknown. The aim of this study was to assess APA prevalence in T1D patients as compared to patients with type 2 diabetes mellitus (T2D) and healthy subjects.

Research design and methods: The presence of APA was assessed by indirect immunofluorescence (IF) technique, with bovine adrenal gland and pituitary as substrates. To avoid non-specific interference only sera giving IF signal at 1:200 dilution were considered as positive. The study groups included 100 patients with T1D of varying duration (median 14 years, range 1 month to 43 years), 32 patients with T2D and 62 healthy controls.

Results: APA were detected in 7 of 100 (7%) patients with IDDM, 0 patients with NIDDM and 0 non diabetic subjects, corresponding to a significant increase (P=0.033 by χ² test) in T1D patients vs healthy controls, while the difference vs T2D was slightly above the level of statistical significance (P=0.124). Evaluation of anterior pituitary function of the seven APA-positive T1D patients is presently under study.

Conclusions: This study indicates that the prevalence of APA is higher in patients with T1D than in the patients with T2D and in non diabetic controls. This observation, which confirms and extends previous reports, suggests that the spectrum of autoimmune disorders associated with T1D should be further expanded. The functional significance of autoimmunity against anterior pituitary requires further investigation, presently ongoing at our Institutions.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.