Journal of Clinical and Cellular Immunology
Open Access
ISSN: 2155-9899
ISSN: 2155-9899
Mei Li N G1, Lim S C2, Liu J J2, Tai E S3, Dalan R4 and Boehm BO1,4
1Nanyang Technological University, Singapore 2Khoo Teck Puat Hospital, Singapore 3National University of Singapore, Singapore 4Tan Tock Seng Hospital, Singapore
Posters-Accepted Abstracts: J Clin Cell Immunol
Introduction: Not much is known on the prevalence of latent autoimmune diabetes of the adult (LADA) in diabetic patients in Singapore. We therefore aimed to estimate the prevalence of islet cell autoimmunity in diabetic patients from Singapore and study the association of autoimmunity with the clinical phenotype. Methods: Written informed consent was obtained from a cohort of 770 type 2 diabetes mellitus (T2DM) patients (542 males, 228 females; mean age of diabetes onset 37.5, age range 32-43). Serum samples were screened for glutamic acid decarboxylase (GADA 65), islet antigen 2 (IA2A) and zinc-transporter 8 (ZnT8A) antibodies using the Diabetes Antibody Standardization Program (DASP) protocol. TPO and gastric proton pump antibodies were also measured. Results: Of the 770 T2DM patients, a total of 68(8.83%) [95% CI: 7.26-10.32%] revealed islet cell antibody positivity. Of these, 62(8.05%) had GADA65 [8.11% males (n=44), 7.92% females (n=18)], 33 (4.95%) had IA2A [3.13% males (n=17), 7.89% females (n=16)], 14 (1.82%) had ZnT8A [1.66% males (n=9), 2.2% females (n=5)]. The overall prevalence of anti-TPO positive was 20.51% (n=158) and this rate was higher in female 29.38% (n=67) compared to male patients 16.61%, (n=91). Patients with autoimmune diabetes have higher prevalence of anti-TPO than non-autoimmune diabetes [27.9% in autoimmune vs. 19.8% in non-autoimmune P<0.05]. Compared to GADA65, ZnT8A positive patients showed the highest prevalence [46.15% in ZnT8A positive vs. 19.35% in GADA65 positive P<0.05 of anti-TPO antibody.] Proton pump antibody positivity was confined to the ZnT8A positive subjects. Patients with GADA65 positivity demonstrated less metabolic syndrome phenotype (lower BMI and higher HDL-C) and higher rates of insulin use and an increased risk of diabetic nephropathy. Discussion & Conclusion: The prevalence of islet cell autoimmunity seems to be remarkably similar in populations of adultonset diabetes patients from Singapore and Europe. Patients with autoimmune diabetes have higher prevalence of thyroid autoimmunity and show an increased risk of nephropathy.
Email: ngmeili@ntu.edu.sg