Abstract

AimsTo assess the prevalence of diabetes-associated autoantibodies in Chinese patients recently diagnosed with adult-onset diabetes and to evaluate the potential role of the autoantibody markers for characterization of disease phenotype in the patient population.MethodsThe study included 1273 recent-onset adult patients with phenotypic type 2 diabetes mellitus (T2DM). Serum samples were tested using the 3-Screen ICA™ ELISA (3-Screen) designed for combined measurement of GADAb and/or IA-2Ab and/or ZnT8Ab. 3-Screen positive samples were then tested for individual diabetes-associated and other organ-specific autoantibodies. Clinical characteristics of patients positive and negative in 3-Screen were analysed.ResultsForty-four (3.5%) of the T2DM patients were positive in 3-Screen, and 38 (86%) of these were also positive for at least one of GADAb, IA-2Ab and ZnT8Ab in assays for the individual autoantibodies. 3-Screen positive patients had lower BMI, higher HbA1c, lower fasting insulin levels and lower fasting C-peptide levels compared to 3-Screen negative patients. Analysis using a homeostatic model assessment (HOMA2) indicated that HOMA2-β-cell function was significantly lower for the forty-four 3-Screen positive patients compared to 3-Screen negative patients.Twenty (45%) 3-Screen positive patients were also positive for at least one thyroid autoantibody.ConclusionsThe 3-Screen ELISA has been used successfully for the first time in China to detect diabetes autoantibodies in patients with phenotypic T2DM. 3-Screen positive patients presented with poorer β cell function.

Highlights

  • Presentation of type 2 diabetes mellitus (T2DM) is typically heterogeneous in different patients [1, 2] with 4–10% of adults clinically diagnosed with T2DM presentingManaged by Massimo Porta.This study aimed to assess the prevalence of diabetesassociated autoantibodies in a cohort of Chinese patients recently diagnosed with adult onset T2DM using the new 3-Screen ICATM ELISA (3-Screen) for the combined ­measurement of GADAb, IA-2Ab and ZnT8Ab in a single serum sample

  • Thirty-eight (86%) sera were positive for at least one of GADAb, IA-2Ab and ZnT8Ab, while six 3-Screen positive samples were found negative in the individual ELISAs

  • For 27 (61%) patients who were positive for one autoantibody only (24 for GADAb only and 3 for ZnT8Ab only), the median 3-Screen value was 77.2 units/mL

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Summary

Introduction

Presentation of type 2 diabetes mellitus (T2DM) is typically heterogeneous in different patients [1, 2] with 4–10% of adults clinically diagnosed with T2DM presenting. This study aimed to assess the prevalence of diabetesassociated autoantibodies in a cohort of Chinese patients recently diagnosed with adult onset T2DM using the new 3-Screen ICATM ELISA (3-Screen) for the combined ­measurement of GADAb, IA-2Ab and ZnT8Ab in a single serum sample. We aimed to evaluate the potential value of the autoantibody markers for characterization of a disease phenotype in particular, the clinical characteristics and metabolic profiles of 3-Screen positive patients compared to 3-Screen negative patients. Recognition of the characteristic disease phenotype may be helpful in tailoring. Acta Diabetologica treatment regimens for 3-Screen positive Chinese adult T2DM patients

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