Lorna Garnier1, Lucien Marchand2, Marine Benoit3, Marc Nicolino4, Nathalie Bendelac4, Catherine Wright5, Philippe Moulin3, Christine Lombard1, Charles Thivolet2, Nicole Fabien6. 1. Immunology Department, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France. 2. Endocrinology and Diabetes Department, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France. 3. Endocrinology and Diabetes Department, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France. 4. Pediatric Endocrinology Department, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France. 5. Pediatric Department, CHU Annecy, Annecy, France. 6. Immunology Department, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, France. Electronic address: nicole.fabien@chu-lyon.fr.
Abstract
AIM OF THE STUDY: Evaluate the added value of screening anti-ZnT8 antibodies (ZnT8A) in addition to the classical anti-GAD (GADA) and anti-IA-2 (IA-2A) antibodies for the diagnosis of type-1 diabetes (T1D) within a large cohort of both children and adults. MATERIALS AND METHODS: Retrospective 2-year study including 516 patients (215 children, 301 adults) who had blood tests at diabetes onset and/or for diabetes classification. ZnT8A, GADA, and IA-2A were analyzed in all samples. RESULTS: Among those individuals included, 142 (28%) were ZnT8A-positive. A total of 228/516 suffered from T1D, of whom 110 (48%) were ZnT8A-positive and 166 (73%) GADA and/or IA-2A positive. When adding ZnT8A to GADA/IA-2A, 184 (81%) patients were positive for ≥1 Ab. Regarding the 122 patients at T1D onset, 75 (61%) were positive for ZnT8A and the proportion of patients with T1D with ≥1 Ab reached 89%. The highest prevalence of ZnT8A was observed in children aged 6-10years. Fourteen of the 124 patients positive for ZnT8A with a known clinical diagnosis suffered from a disease other than T1D. CONCLUSIONS: ZnT8A should be included in routine evaluation at diabetes onset and is a valuable biological marker to classify newly-diagnosed diabetics. The predictive value in our high-risk subjects has to be confirmed.
AIM OF THE STUDY: Evaluate the added value of screening anti-ZnT8 antibodies (ZnT8A) in addition to the classical anti-GAD (GADA) and anti-IA-2 (IA-2A) antibodies for the diagnosis of type-1 diabetes (T1D) within a large cohort of both children and adults. MATERIALS AND METHODS: Retrospective 2-year study including 516 patients (215 children, 301 adults) who had blood tests at diabetes onset and/or for diabetes classification. ZnT8A, GADA, and IA-2A were analyzed in all samples. RESULTS: Among those individuals included, 142 (28%) were ZnT8A-positive. A total of 228/516 suffered from T1D, of whom 110 (48%) were ZnT8A-positive and 166 (73%) GADA and/or IA-2A positive. When adding ZnT8A to GADA/IA-2A, 184 (81%) patients were positive for ≥1 Ab. Regarding the 122 patients at T1D onset, 75 (61%) were positive for ZnT8A and the proportion of patients with T1D with ≥1 Ab reached 89%. The highest prevalence of ZnT8A was observed in children aged 6-10years. Fourteen of the 124 patients positive for ZnT8A with a known clinical diagnosis suffered from a disease other than T1D. CONCLUSIONS:ZnT8A should be included in routine evaluation at diabetes onset and is a valuable biological marker to classify newly-diagnosed diabetics. The predictive value in our high-risk subjects has to be confirmed.