Autoantibodies against beta cells to predict early insulin requirements in pediatric patients with clinically diagnosed type 2 diabetes

doi:10.4239/wjd.v15.i8.1717

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 15, Issue 8

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (1917)

All Articles published online

The chart showing PDF series, HTML series, Tables (1-7) series.

Item

Count

PDF

HTML

889

Tables (1-7)

144

Sum=1068

Featured Article

The chart showing Browse series, Download series.

Item

Count

Browse

184

Download

363

Sum=547

Publishing Process of This Article

Item

Count

Browse

Download

160

Sum=216

Aug 15, 2024 (publication date) through Jan 10, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Diabetes

ISSN

1948-9358

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Control Study

World J Diabetes. Aug 15, 2024; 15(8): 1717-1725
Published online Aug 15, 2024. doi: 10.4239/wjd.v15.i8.1717

Table 1 Demographic characteristics by insulin dependence, mean ± SD

Variable	Total (n = 132)	No insulin dependence (n = 64)	Insulin dependence (n = 68)	P value
Sex (M) (%)	71 (53.8)	34 (53.1)	37 (54.4)	0.51
Age (years)	15.9 ± 1.3	15.98 ± 1.3	15.9 ± 1.4	0.85
Weight (kg)	73.4 ± 10.1	72.2 ± 10.4	74.5 ± 9.8	0.06
Height (cm)	165.3 ± 6.4	164.7 ± 6.5	165.9 ± 6.3	0.11
BMI (kg/m²)	25.2 ± 3.5	24.9 ± 3.8	25.5 ± 3.1	0.09
BMI z-score	1.39 ± 0.44	1.35 ± 0.46	1.43 ± 0.41	0.42
WC (cm)	87.4 ± 9.9	85.1 ± 10.6	89.1 ± 8.9	0.22
WHtR	0.52 ± 0.05	0.52 ± 0.06	0.53 ± 0.04	0.08
SBP (mm/Hg)	111.6 ± 11.2	110.3 ± 10.7	112.9 ± 11.6	0.05
DBP (mm/Hg)	72.0 ± 8.5	70.6 ± 7.8	73.3 ± 9.0	0.1
DD (years)	4.49 ± 0.88	4.73 ± 0.09	4.27 ± 0.70	0.03

BMI: Body mass index; WC: Waist circumference; WHtR: Waist-to-height ratio; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; DD: Diabetes duration in years.

Table 2 Metabolic characteristics by insulin dependence, mean ± SD

Variable	Total (n = 132)	No insulin dependence (n = 64)	Insulin dependence (n = 68)	P value
TC (mg/dL)	175.9 ± 48.3	164.2 ± 37.4	186.9 ± 54.8	0.54
HDL-C (mg/dL)	44.1 ± 9.3	44.6 ± 7.5	43.6 ± 10.8	0.11
LDL-C (mg/dL)	107.1 ± 41.1	93.3 ± 28.8	118.3 ± 47.5	0.1
TG (mg/dL)	158.5 ± 21.1	148.5 ± 14.0	187.9 ± 19.9	0.18
Fasting glucose (mmol/L)	10.95 ± 0.55	7.62 ± 0.37	14.07 ± 0.51	0.08
HbA1c (%)	8.8 ± 2.9	6.7 ± 1.6	10.8 ± 2.3	0.001
Insulin (mUI/mL)	11.4 ± 7.7	12.7 ± 9.6	10.3 ± 5.0	0.3
C- peptide (ng/dL)	1.4 ± 1.3	2.53 ± 1.2	0.41 ± 0.36	0.001
HOMA-β	85.38 ± 16.6	125.5 ± 15.6	50.9 ± 16.8	0.022

TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein-cholesterol; TG: Triglycerides; HbA1c: Glycated hemoglobin A1c; HOMA-β: Homeostatic model assessment of beta cell function.

Table 3 Demographic characteristics by autoimmunity

Variable	At the time of diagnosis	NID		P value	At the time of diagnosis	ID		P value
Variable	NID (n = 64)	(Ab+) (n = 16)	(Ab-) (n = 48)	P value	ID (n = 68)	(Ab+) (n = 27)	(A-) (n = 41)	P value
Sex (F) (%)		8 (50.0)	26 (54.1)	0.77		16 (59.2)	21 (51.2)	0.51
Age (years)	12.9 ± 0.7	15.9 ± 1.4	16.0 ± 1.3	0.87	13.1 ± 0.9	16.1 ± 1.4	15.7 ± 1.4	0.3
Weight (kg)	68.9 ± 13.9	67.2 ± 11.2	73.9 ± 9.6	0.04	74.6 ± 10.5	73.6 ± 8.4	75.0 ± 10.6	0.57
Height (cm)	159.2 ± 6.0	161.7 ± 7.6	165.7 ± 5.9	0.03	162.2 ± 5.96	165.9 ± 6.2	166.0 ± 6.5	0.95
BMI (kg/m²)	26.0 ± 5.0	24.8 ± 3.3	25.0 ± 4.0	0.81	26.6 ± 4.2	25.6 ± 2.5	25.4 ± 3.5	0.85
BMI z-score	1.61 ± 0.6	1.25 ± 0.4	1.38 ± 0.4	0.31	1.68 ± 0.4	1.40 ± 0.3	1.46 ± 0.4	0.52
WC (cm)	92.6 ± 9.4	85.9 ± 9.5	85.1 ± 11.1	0.91	94.6 ± 10.8	89.0 ± 7.1	89.1 ± 10.0	0.95
WHtR (cm)	0.56 ± 0.06	0.53 ± 0.05	0.51 ± 0.07	0.47	0.56 ± 0.06	0.53 ± 0.03	0.53 ± 0.50	0.94
SBP (mmHg)	112 ± 12.2	109.8 ± 10.0	110.5 ± 11.0	0.82	18 ± 14.6	112.3 ± 13.2	113.2 ± 10.6	0.75
DBP (mmHg)	74.5 ± 8.4	70.7 ± 7.0	70.6 ± 8.1	0.96	78.8 ± 9.2	73.1 ± 10.2	73.5 ± 8.2	0.86
DD (years)		4.76 ± 0.95	4.72 ± 0.09	0.87		4.38 ± 0.82	4.19 ± 0.73	0.34

NID: No insulin dependence; ID: Insulin dependent; Ab: Antibodies; BMI: Body mass index; WC: Waist circumference; WHtR: Waist-to-height ratio; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; DD: Diabetes duration in years.

Table 4 Metabolic characteristics of the groups by autoimmunity

Variable	At the time of diagnosis	NID		P value	At the time of diagnosis	ID		P value
Variable	NID (n = 64)	Ab+) (n = 16)	(Ab-) (n = 48)	P value	ID (n = 68)	(Ab+) (n = 27)	(A-) (n = 41)	P value
TC (mg/dL)	164.8 ± 39	170 ± 32.9	162.1 ± 38.8	0.44	170 ± 37.5	189.2 ± 60.7	185.3 ± 51.3	0.77
HDL-C (mg/dL)	41.9 ± 11.4	45.8 ± 6.9	44.1 ± 7.7	0.42	43.6 ± 8.0	42.2 ± 8.0	44.5 ± 12.4	0.39
LDL-C (mg/dL)	97.9 ± 30	96.8 ± 23.2	94.8 ± 30.6	0.82	96.2 ± 29.3	124.8 ± 51.6	114.0 ± 44.8	0.38
TG (mg/dL)	136.4 ± 28	162.5 ± 21.1	143.8 ± 11.0	0.65	153.3 ± 22	172.6 ± 9.8	164.8 ± 10.9	0.75
Glucose (mmol/L)	14.77 ± 2.16	7.58 ± 2.93	7.64 ± 3.97	0.96	13.27 ± 2.55	13.66 ± 0.54	14.68 ± 0.25	0.43
HbA1c (%)	9.7 ± 2.7	6.8 ± 1.8	6.3 ± 0.9	0.91	9.2 ± 2.2	11.4 ± 2.6	10.4 ± 2.1	0.09
Insulin (mUI/mL)	16.7 ± 1.6	9.3 ± 4.8	13.8 ± 9.5	0.02	21.1 ± 2.8	9.5 ± 3.7	10.7 ± 5.7	0.04
C-peptide (ng/mL)	0.3 ± 0.09	2.3 ± 1.2	2.6 ± 1.2	0.42	1.1 ± 0.26	0.30 ± 0.25	0.40 ± 0.04	0.19
HOMA-β	72.3 ± 33.9	64.8 ± 45.3	125.7 ± 15.8	0.02	91.5 ± 30.6	25.8 ± 34.6	61.3 ± 20.2	0.02

NID: No insulin dependence; ID: Insulin dependent; TC: total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein-cholesterol; TG: Triglycerides; HbA1c: Glycated hemoglobin A1c; HOMA-β: Homeostatic model assessment of beta-cell function.

Table 5 Frequency of antibody positivity, n (%)

Variable	Total (n = 132)	No insulin dependence (n = 64)	Insulin dependent (n = 68)	P value
Anti-GAD 65	39 (29.5)	13 (20.3)	26 (38.2)	0.02
Anti-IA2	24 (18.2)	8 (12.5)	16 (23.5)	0.07
Anti-Zn8T	21 (15.9)	3 (4.7)	18 (26.5)	0
Anti-GAD65 + anti-IA2	20 (15.2)	5 (7.8)	15 (22.1)	0.02
Anti-GAD65 + anti-Zn8T	15 (11.4)	3 (4.7)	12 (17.6)	0.01
Anti-IA2 + anti-Zn8T	12 (9.1)	2 (3.1)	10 (14.7)	0.02
Three antibodies	12 (9.1)	2 (3.1)	10 (14.7)	0.02

GAD65: Glutamic acid decarboxylase; IA2: Islet antigen 2; Zn8T: Zinc transporter 8.

Table 6 Antibody titers according to insulin dependence

Variable	Total (n = 132)	No insulin dependence (n = 64)	Insulin dependent (n = 68)	P value
Anti-GAD65 (UI/mL)	11.0 (5-543)	6.8 (5-543)	12.0 (5-186)	0.69
Anti-IA2 (UI/mL)	14.6 (5-245)	8.45 (5-111)	21.6 (5-245)	0.6
Anti-Zn8T (UI/mL)	68.5 (15.9-178.2)	64.5 (47-74.5)	73.7 (15.9-178.2)	0.68

Median and minimum and maximum ranges. Mann–Witney U test. GAD65: Glutamic acid decarboxylase; IA2: Islet antigen 2; Zn8T: Zinc transporter 8.

Table 7 Estimation of risks according to antibodies

Variable	Odds ratio early insulin requirements (n = 132)
Variable	OR adj (95%CI)	P value
Anti-GAD65	2.42 (1.112- 5.303)	0.026
Anti-IA2	1.55 (0.859- 2.818)	0.101
Anti-Zn8T	7.32 (2.039-26.279)	0.002
Anti-GAD65 + Anti-IA2	3.34 (1.136- 9.814)	0.028
Anti-GAD65 + anti-Zn8T	4.35 (1.168-16.248)	0.028
Anti-IA2 + anti-Zn8T	5.34 (1.123-25.431)	0.035
Anti-GAD65 + Anti-IA2 + anti-Zn8T	5.34 (1.123-25.431)	0.035

Adjusted for age, body mass index, and time of evolution of diabetes. GAD65: Glutamic acid decarboxylase; IA2: Islet antigen 2; Zn8T: Zinc transporter 8.

Citation: Molina JM, Medina PG, Gomez RA, Herrera JR, Martínez NL, Hernández B, García Y. Autoantibodies against beta cells to predict early insulin requirements in pediatric patients with clinically diagnosed type 2 diabetes. World J Diabetes 2024; 15(8): 1717-1725
URL: https://www.wjgnet.com/1948-9358/full/v15/i8/1717.htm
DOI: https://dx.doi.org/10.4239/wjd.v15.i8.1717