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Diabetes Metab Res Rev. 2013 Jul;29(5):363-8. doi: 10.1002/dmrr.2396.

Zinc transporter 8 autoantibody (ZnT8A) could help differentiate latent autoimmune diabetes in adults (LADA) from phenotypic type 2 diabetes mellitus.

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  • 1Diabetes Center, Second Xiangya Hospital, and Institute of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, Hunan, China.

Abstract

BACKGROUND:

The ZnT8A is an independent marker for diagnosis of type 1 diabetes mellitus. We investigated the distribution and clinical features of ZnT8A positive latent autoimmune diabetes in adult (LADA) patients to explore the potential diagnostic application.

METHODS:

A total of 3062 phenotypic T2DM patients were randomly selected from a national multicenter study - the LADA China Study. Radioligand binding assays were applied to detect the presence of ZnT8A, GADA and IA-2A. HbA1c , fasting C-peptide and serum lipid levels were followed up with ZnT8A positive patients.

RESULTS:

The positive prevalence of ZnT8A, GADA and IA-2A in phenotypic T2DM patients was 1.99% (61/3062), 6.43% (197/3062) and 1.96% (60/3062), respectively. The ZnT8A positivity was lower than that of GADA(x²  = 74.8, p < 0.001) but was comparable with that of IA-2A (p > 0.05). The positivity of ZnT8A in IA-2A positive patients was higher than that in GADA positive patients (38.3% vs. 10.7%, x²  = 24.8, p < 0.001). On the basis of GADA and IA-2A positivity, the ZnT8A assay enhanced the diagnostic prevalence of LADA from 7.58 to 8.62%. The LADA patients who were positive for ZnT8A had higher systolic blood pressure when compared with GADA positive cases (p = 0.049) and higher total cholesterol levels when compared with antibody-negative T2DM patients (p = 0.035).

CONCLUSION:

The detection of ZnT8A at the basis of GADA and IA-2A can improve diagnostic sensitivity of Chinese LADA.

Copyright © 2013 John Wiley & Sons, Ltd.

KEYWORDS:

autoantibody; latent autoimmune diabetes in adults; type 2 diabetes mellitus; zinc transporter 8; β-cell function

[PubMed - indexed for MEDLINE]
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