Autoimmunity markers in subjects with diabetes
Treść / Zawartość
Introduction. Diabetes is a growing social and epidemiological problem. Accordingly, the incidence of complications associated with diabetes can cause a persistent high percentage of diseases of the cardiovascular system, kidney and nervous systems, and impaired vision. Objective. The aim of the study was to evaluate the incidence of immunological markers in patients with type 1 diabetes and those with type 2 diabetes: the anti-GAD, ANA, AMA, ASMA, APCA and LKM, compared to healthy people. Another objective of the study was to evaluate the correlation between their presence and the degree of metabolic control in both groups. Materials and methods. The study comprised 100 subjects aged 25–75 years with a body mass index (BMI) between 20–30 kg / m2, hospitalized in the Department of Internal Diseases, Diabetology and Endocrinology, at the Medical University of Warsaw, with previously diagnosed diabetes who were assigned to one of 2 groups (50 subjects with type 1 diabetes and 50 subjects with type 2 diabetes). The control group consisted of 21 healthy individuals without the diagnosis of diabetes and a prediabetic state. All the study participants had the examined antibodies determined along with the panel of biochemical tests and neurological examination for diabetic neuropathy and fundus examination. Results. Anti-GAD antibodies were present in both groups of patients. Their presence was found in 30% of people with type 1 diabetes and in 16% of people with diabetes type 2. The presence of ANA antibodies was found in 24% of people with type 1 diabetes and 22% of people with type 2 diabetes. There was no correlation between the presence of ANA antibodies ANA and duration of diabetes. In the group of patients with type 1 diabetes, there was a correlation between the presence of ANA and the incidence of diabetic polyneuropathy. ASMA and APCA antibodies occurred with equal frequency in both studied groups (4% vs. 10%). There were no antibodies of AMA or anti-LKM in any of the patients. Conclusions. Marking of ANA antibodies in patients with type 1 diabetes may be a marker used to isolate a group of patients at risk of developing diabetic neuropathy. The presence of anti-GAD in type 2 diabetes may be a LADA marker which specifically marks the group of patients with type 2 diabetes, in whom there is a faster metabolic death of beta cells. The current classification of diabetes is vague, and in the near future it should be modified based on specific patient characteristics, phenotypic appearance, as well as the results of additional tests. Determination of antibodies AMA, ASMA, APCA and anti-LKM does not seem to be significant in the diagnosis of diabetes and its chronic complications.