ICEECE2012 Poster Presentations Diabetes (248 abstracts)
High prevalence of autoimmunity in adult onset diabetes subjects with high GADA titre
S Zampetti 1 , M Capizzi 1 , M Spoletini 1 , G Campagna 1 , L Cipolloni 1 , A Petrone 1 , C Tiberti 1 , S Di Pietro 2 , M Locatelli 3 , A Falorni 4 , E Bosi 5 , R Buzzetti 1 & Nirad Study Group (Italian Society of Diabetes) 1
1Sapienza University, Rome, Italy; 2INRCA, Rome, Italy; 3Bambino Gesu` Hospital, Rome, Italy; 4Università Perugia, Perugia, Italy; 5San Raffaele, Milano, Italy.
Introduction: LADA is a heterogeneous population of diabetes subjects wherein subgroups can be identified based on their autoimmune status: the titre of autoantibodies to GAD.
The aim of the study was to correlate, in LADA subjects, GADA titre, with the presence of other organ and non organ specific autoantibodies.
Methods: LADA subjects (n=191) and type 2 diabetes (T2DM) subjects (n=382) were selected from the Non Insulin Requiring Autoimmune Diabetes cohort. GADA titre showed a bimodal distribution (high (>32 GADA U) or low GADA titre (≤32 GADA U). The following autoantibodies were measured: protein tyrosine phosphatase IA-2 (IA–2A), thyroid peroxidase antibodies, (TPO), steroid-21-hydroxylase (21OHAb), anti-parietal cell antibodies (APCA), tissue transglutaminase antibody IgA (tTGA). IA–2A, 21 OHAb, TPO, IgA, tTGA antibodies were measured by a radioimmunoassay and APCA by a ELISA method.
Results: Subjects with high GADA titer compared to low GADA titer showed a significantly higher prevalence of TPOAb (37.2 vs 16.5%; P=0.002), IA – 2AIC (25.5 vs 8.2%; P<0.002), APCA (23.3 vs 9.3%; P<0.01) and ZnT8 (29.7 vs 8.2%; P <0.0003). A significant decreasing trend was observed from high GADA titre to low GADA titer and to T2DM for the prevalence of TPO and tTGA (P<0.001 for both comparisons). 21OHAb showed a prevalence of 3.2% in high GADA titer and were not present neither in low GADA titer nor in T2DM subjects. The prevalence of tTGA was of 4% in high GADA titer, 1.2% in low GADA and 0.4% in T2DM (P for trend=0.001, high GADA vs T2DM P=0.03).
Conclusion: High GADA titre, in LADA subjects, is associated with a profile of more severe autoimmunity. Previous studies indicate that the prevalence of multiple autoantibodies is a better index of disease progression than prevalence of antibodies directed at individual antigens. This may indicate intermolecular epitope spreading that can amplifies the autoimmune response.
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 work was supported, however funding details unavailable.
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Endocrine Abstracts
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