Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

The aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

[1]  O. Kordonouri,et al.  Screening frequency for celiac disease and autoimmune thyroiditis in children and adolescents with type 1 diabetes mellitus – data from a German/Austrian multicentre survey , 2008, Pediatric diabetes.

[2]  D. Becker,et al.  Thyroid autoimmunity in children with features of both type 1 and type 2 diabetes , 2008, Pediatric diabetes.

[3]  A. Okten,et al.  Screening of diabetes, thyroid, and celiac diseases-related autoantibodies in a sample of Turkish children with type 1 diabetes and their siblings. , 2008, Diabetes research and clinical practice.

[4]  B. Frier,et al.  Thyroid Autoimmunity at Onset of Type 1 Diabetes as a Predictor of Thyroid Dysfunction , 2007, Diabetes Care.

[5]  U. John,et al.  The spectrum of thyroid disorders in adult type 1 diabetes mellitus , 2007, Diabetes/metabolism research and reviews.

[6]  J. Lazarus,et al.  Islet cell, thyroid, adrenal and celiac disease related autoantibodies in patients with Type 1 diabetes from Sri Lanka , 2006, Journal of endocrinological investigation.

[7]  P. Koşucu,et al.  Iodine status, thyroid function, thyroid volume and thyroid autoimmunity in patients with type 1 diabetes mellitus in an iodine-replete area. , 2006, Diabetes & metabolism.

[8]  M. Koziński,et al.  Thyroid ultrasound in diabetic patients without overt thyroid disease , 2006, Acta radiologica.

[9]  O. Kordonouri,et al.  Natural course of autoimmune thyroiditis in type 1 diabetes: association with gender, age, diabetes duration, and puberty , 2005, Archives of Disease in Childhood.

[10]  Y. Tomer,et al.  The etiology of autoimmune diabetes and thyroiditis: evidence for common genetic susceptibility. , 2003, Autoimmunity reviews.

[11]  A. Kitabchi,et al.  Thyroid dysfunction in patients with type 1 diabetes: a longitudinal study. , 2003, Diabetes care.

[12]  O. Kordonouri,et al.  Thyroid autoimmunity in children and adolescents with type 1 diabetes: a multicenter survey. , 2002, Diabetes care.

[13]  R. Leelawattana,et al.  Thyroid autoantibodies in Thai type 1 diabetic patients: clinical significance and their relationship with glutamic acid decarboxylase antibodies. , 2000, Diabetes research and clinical practice.

[14]  J. Hwang,et al.  Relationship between autoantibodies against glutamic acid decarboxylase, thyroglobulin/thyroid microsome and DNA topoisomerase II in the clinical manifestation of patients with type 1 diabetes mellitus in Taiwan. , 2000, European journal of endocrinology.

[15]  L. Hegedüs,et al.  Thyroid function, morphology and autoimmunity in young patients with insulin-dependent diabetes mellitus. , 1999, European journal of endocrinology.

[16]  L. Chuang,et al.  Autoantibodies to thyroid peroxidase in patients with type 1 diabetes in Taiwan. , 1998, European journal of endocrinology.

[17]  J. S. Swan,et al.  Hashimoto's thyroiditis and insulin-dependent diabetes mellitus: differences among individuals with and without abnormal thyroid function. , 1998, The Journal of clinical endocrinology and metabolism.

[18]  R. Ljung,et al.  High prevalence of thyroid autoantibodies at diagnosis of insulin-dependent diabetes mellitus in Swedish children. , 1997, The Journal of laboratory and clinical medicine.

[19]  P. Bingley,et al.  Prediction of IDDM in the General Population: Strategies Based on Combinations of Autoantibody Markers , 1997, Diabetes.

[20]  G. Marchesini,et al.  Thyroid volume in type 1 diabetes patients without overt thyroid disease , 1995, Acta Diabetologica.

[21]  M. Rowley,et al.  Anti-glutamate decarboxylase and other antibodies at the onset of childhood IDDM: a population-based study , 1994, Diabetologia.

[22]  T. Tai,et al.  HLA-DQB1 Codon 57 and IDDM in Chinese Living in Taiwan , 1994, Diabetes Care.

[23]  S. Nagataki,et al.  Autoantibodies to Glutamic Acid Decarboxylase in Patients with IDDM and Autoimmune Thyroid Disease , 1994, Diabetes.

[24]  L. Harrison,et al.  An ELISA for Antibodies to Recombinant Glutamic Acid Decarboxylase in IDDM , 1992, Diabetes.

[25]  W. Scherbaum,et al.  Glutamic acid decarboxylase (GAD) autoantibodies are additional predictive markers of Type 1 (insulin-dependent) diabetes mellitus in high risk individuals , 1992, Diabetologia.

[26]  L. Grimaldi,et al.  Autoantibodies to glutamic acid decarboxylase (GAD) detected by an immuno-trapping enzyme activity assay: relation to insulin-dependent diabetes mellitus and islet cell antibodies. , 1991, Journal of autoimmunity.

[27]  S. Nagataki,et al.  Islet Cell Antibodies in Patients With Autoimmune Thyroid Disease , 1991, Diabetes.

[28]  S. Sostre,et al.  Sonographic diagnosis and grading of Hashimoto’s thyroiditis , 1991, Journal of endocrinological investigation.

[29]  Lucas Mantovani,et al.  Thyroid Autoimmunity in Children and Adolescents with Type 1 Diabetes Mellitus: Prevalence and Risk Factors , 2007, Journal of pediatric endocrinology & metabolism : JPEM.

[30]  M. Hill,et al.  Anti-GAD-positive patients with type 1 diabetes mellitus have higher prevalence of autoimmune thyroiditis than anti-GAD-negative patients with type 1 and type 2 diabetes mellitus. , 2004, Physiological research.

[31]  R. Bretzel,et al.  Comparative analysis of organ-specific autoantibodies and celiac disease--associated antibodies in type 1 diabetic patients, their first-degree relatives, and healthy control subjects. , 2001, Diabetes care.

[32]  C. Fajardo,et al.  Influence of age on clinical and immunological characteristics of newly diagnosed type 1 diabetic patients , 2001, Acta Diabetologica.

[33]  F. Baş,et al.  Thyroid Ultrasound in IDDM , 1994, The Journal of pediatric endocrinology.

[34]  A Pinchera,et al.  Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism. , 1991, The Journal of clinical endocrinology and metabolism.