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

• DOI: 10.1002/dmrr.2396
• Publication Date: 2013-02-07T05:24:26Z
• Authors: Gan Huang; Yufei Xiang; Lingling Pan; Xia Li; Shuoming Luo; Zhiguang Zhou
• Keywords: Adult; Aged, 80 and over; Male; China; Glutamate Decarboxylase; Middle Aged; Sensitivity and Specificity; 3. Good health; Autoimmune Diseases; Diagnosis, Differential; Radioligand Assay; 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; Diabetes Mellitus, Type 2; Case-Control Studies; Prevalence; Humans; Receptor-Like Protein Tyrosine Phosphatases, Class 8; Cation Transport Proteins; Aged; Autoantibodies; Follow-Up Studies

AbstractBackgroundThe 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.MethodsA 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.ResultsThe 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).ConclusionThe detection of ZnT8A at the basis of GADA and IA‐2A can improve diagnostic sensitivity of Chinese LADA. Copyright © 2013 John Wiley & Sons, Ltd.