Autoantibody "subspecificity" in type 1 diabetes: risk for organ-specific autoimmunity clusters in distinct groups

• Published in: Diabetes care Vol. 28; no. 4; pp. 850 - 855
• Main Authors: Barker, Jennifer M, Yu, Jeesuk, Yu, Liping, Wang, Jian, Miao, Dongmei, Bao, Fei, Hoffenberg, Edward, Nelson, Jerald C, Gottlieb, Peter A, Rewers, Marian, Eisenbarth, George S
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.04.2005
• Subjects: Adolescent; Antibody Specificity; Autoantibodies - blood; Autoimmune Diseases - epidemiology; Autoimmune Diseases - immunology; Celiac Disease - blood; Celiac Disease - immunology; Child; Child, Preschool; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - immunology; Female; HLA Antigens - immunology; Humans; Iodide Peroxidase - immunology; Lymphatic system; Male; Medical disorders; Organ Specificity; Prevalence; Risk Factors; Thyroglobulin - immunology
• ISSN: 0149-5992
• DOI: 10.2337/diacare.28.4.850

Autoimmune thyroid disease (AIT), celiac disease, and Addison's disease are characterized by the presence of autoantibodies: thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in AIT, tissue transglutaminase antibody (TTGAb) in celiac disease, and 21-hydroxylase antibody (21-OHAb) in Addison's disease. The objective of this study was to define the prevalence of these autoantibodies and clinical disease in a population with type 1 diabetes. We screened 814 individuals with type 1 diabetes for TPOAb, TGAb, TTGAb, and 21-OHAb. Clinical disease was defined by chart review. Factors related to the presence of autoimmunity and clinical disease including age at onset of type 1 diabetes, duration of diabetes, age at screening, sex, and the presence of autoantibodies were reviewed. The most common autoantibodies expressed were TPOAb and/or TGAb (29%), followed by TTGAb (10.1%) and 21-OHAb (1.6%). Specific HLA DR/DQ genotypes were associated with the highest risk for expression of 21-OHAb (DRB1*0404-DQ8, DR3-DQ2) and TTGAb (DR3-DQ2- DR3-DQ2). The expression of thyroid autoantibodies was related to 21-OHAb but not to TTGAb. The presence of autoantibodies was associated with and predictive of disease. In this large cohort of individuals with type 1 diabetes, the expression of organ-specific autoantibodies was very high. The grouping of autoantibody expression suggests common factors contributing to the clustering.