Abstract
PurposeThe aim of this work was to investigate, in patients with newly diagnosed Graves’ disease (GD), the frequency of islet autoantibodies including autoantibodies against Zink transporter 8 (ZnT8A), as well as to investigate the relation between thyroid autoantibodies, islet autoantibodies and diabetes both before GD diagnosis and at follow-up.MethodsBlood samples from 278 patients with newly diagnosed GD were analyzed for autoantibodies against glutamic acid decarboxylase (GADA), insulinoma-associated protein-2 (IA2-A), three variants of zinc transporter 8 (ZnT8A), thyroid peroxidase (TPOA) and the TSH receptor (TRAb). Information on other autoimmune diseases, as well as development of diabetes during follow up was gathered from patient’s medical journal.ResultsAt GD diagnosis, 13.7% were positive for islet autoantibodies, with the majority being positive for GADA (8.7%) and ZnT8A (7.6%). TPOA were found positive in 71% and TRAb in 83%. No association was found between islet autoantibodies and thyroid autoantibodies or diabetes diagnosis during follow up. Positive association was found between islet autoantibodies and all forms of diabetes, diagnosed both before and after GD (OR: 2.5, CI: 1.1–6.8, p = 0.03) but not to other autoimmune diseases at GD diagnosis.ConclusionsThe incidence of GADA and ZnT8A in patients with GD is high and might indicate wide range endocrine autoimmunity, as well as risk for non-autoimmune diabetes rather than exclusively mark beta cell autoimmunity and type 1 diabetes.
Highlights
Graves’ disease (GD) and autoimmune type 1 diabetes (T1D) are common organ specific autoimmune endocrine disorders that may co-occur [1]
Patients with positive islet autoantibodies at GD diagnosis were more likely to have any form of diabetes, diagnosed before GD or at follow up (OR 2.7, CI; 1.1–6.8, Table 2 Description of the cohort with and without islet autoantibodies at Graves ‘disease (GD) diagnosis and associations to age, gender, place of birth, other autoimmune disease at diagnosis, smoking, Gravesopthalmopathy and any form of diabetes diagnosed before Graves ‘disease or at follow up GD patients with positive GD patients without islet OR CI 95% p value islet Ab (n = 38)
In this study of 278 patients with GD, we found the prevalence of islet autoantibodies to be 13.7% at GD diagnosis with the highest prevalence of glutamic acid decarboxylase (GADA) and ZnT8A
Summary
Graves’ disease (GD) and autoimmune type 1 diabetes (T1D) are common organ specific autoimmune endocrine disorders that may co-occur [1]. T1D is characterized by immune mediated destruction of the pancreatic beta cell, reflected by autoantibodies against glutamic acid decarboxylase (GADA), insulinoma-associated protein-2 The predictive value of islet autoantibodies is thoroughly studied and at present well recognized [4, 5], their pathogenic role is unclear. GD is, in contrast to T1D, characterized by activating autoantibodies to the thyroid hormone stimulation receptor (TRAb). These autoantibodies stimulates thyroid hormone production resulting in thyrotoxicosis [6]. Autoantibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb), can be found in GD patients, more characteristic for the other phenotype of autoimmune thyroid disease, Hashimoto’s thyroiditis, often associated with impaired thyroid function
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
