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1. Prevalence of pancreatic autoantibodies in non-diabetic patients with autoimmune thyroid disease and its relation to insulin secretion and glucose tolerance.

Author

Sallorenzo C, Silva R, Kasamatsu T, and Dib S

Subjects
Adolescent, Adult, Aged, Female, Glucose Tolerance Test, Glutamate Decarboxylase blood, Graves Disease blood, Hashimoto Disease blood, Humans, Insulin blood, Insulin Secretion, Male, Middle Aged, Protein Tyrosine Phosphatases blood, Young Adult, Autoantibodies analysis, Blood Glucose analysis, Glutamate Decarboxylase immunology, Graves Disease enzymology, Hashimoto Disease enzymology, Insulin metabolism, Protein Tyrosine Phosphatases immunology
Abstract

Objective: We evaluated the prevalence of glutamic acid decarboxylase (GADA) and tyrosine phosphatase-protein antibodies (IA2A), their titers and their relation to first phase insulin response (FPIR) and glucose tolerance in autoimmune thyroid diseases (ATDs) patients., Subjects and Methods: Graves' disease (GD; n = 181) and Hashimoto's thyroiditis (HT; n = 143) patients in addition to healthy controls (n = 93) were studied. Secondly, FPIR and oral glucose tolerance tests (OGTT) were performed in 11 anti-pancreatic islet-cell (+) and in 20 anti-pancreatic-cell (-) patients., Results: There was a non significant trend for higher prevalence of GADA positivity in GD vs HT (7.2% vs 2% p = 0.06), but the GADA titers were higher in HT. We also did not find a significant difference in IA2 prevalence (0.7% vs 0.0%) between these two groups or compared to the control group. In the subsequent analysis, low FPIR was found in 10% of these patients but without statistical difference for OGTT between pancreatic antibody-positive and -negative patients., Conclusion: A trend for greater prevalence of GADA was observed for GD patients than for HT or control. However, the titers of these autoantibodies were higher in HT patients, but there was no significant relation to insulin secretion and glucose tolerance at that moment and stage of autoimmune diseases.

Published
2017
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2. Autoantibodies against glutamic acid decarboxylase and 21-hydroxylase in Brazilian patients with type 1 diabetes or autoimmune thyroid diseases

Author

Silva, R., Sallorenzo, C., Kater, C., Dib, S., and Falorni, Alberto

Subjects
Adult, Blood Glucose, Male, diabete mellito, tiroide, Adolescent, Hydrocortisone, autoanticorpi, Iodide Peroxidase, Addison Disease, Adrenocorticotropic Hormone, Renin, Humans, Insulin, Child, Aldosterone, Aged, Autoantibodies, morbo di addison, Glutamate Decarboxylase, Receptors, Thyrotropin, Fasting, Glucose Tolerance Test, Middle Aged, Thyroid Diseases, Diabetes Mellitus, Type 1, Female, Steroid 21-Hydroxylase, Biomarkers, Brazil, Follow-Up Studies, Immunoglobulins, Thyroid-Stimulating
Abstract

Autoimmune thyroid diseases (ATD) are often associated with Type 1 diabetes mellitus (T1DM) and Addison's disease (AD), characterizing the autoimmune polyendocrine syndrome. We evaluated the frequency of autoantibodies against glutamic acid decarboxylase isoform 65 (GAD65Ab) and 21-hydroxylase (21OHAb) in the sera of 65 [58 females (F)/7 males (M), 17-70 yr] patients with Graves' disease (GD) and 47 (45 F/2 M, 12-77 yr) with Hashimoto's thyroiditis (HT), none of whom had either diabetes or AD. The sera of 30 recently diagnosed T1DM patients (16 M/14 F, 1-39 yr) and of 97 (54 F/43 M, 7-69 yr) healthy controls were also examined. GAD65Ab were detected in the sera of 18 (60%) T1DM, 8 (12%) GD and in none of the HT patients or the controls (p = 0.03 for GD vs HT, p = 0.002 for GD vs controls, and p0.001 for GD vs T1DM). 21OHAb were detected in the sera of 2 (3%) GD, 1 (2%) HT and in none of the T1DM patients or the controls. GAD65Ab levels were significantly lower in GD than in T1DM patients (median: -0.06 vs 0.28, p0.001). Six of the 8 GD GAD65Ab-positive patients submitted to an intravenous glucose tolerance test showed no diminished first phase insulin secretion. All 21OHAb positive patients had normal basal cortisol and adrenocorticotropin (ACTH), normal cortisol response after ACTH stimulation, but high plasma renin activity. In conclusion, despite the genetic diversity of the Brazilian population, the frequency of GAD65Ab and 21OHAb in our patients is similar to that observed in other countries. GAD65Ab were more prevalent in GD than in HT patients, suggesting a difference in the immune response between these disorders. Long-term follow-up is necessary to determine the clinical relevance of these autoantibodies in the Brazilian population.

Published
2003

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