Journal of Mazandaran University of Medical Sciences
مجله دانشگاه علوم پزشکی مازندران
J Mazandaran Univ Med Sci
Medical Sciences
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فراوانی اتوآنتی بادی های ضد سلولهای بتای پانکراس در کودکان مبتلا به دیابت قندی نوع یک
Prevalence of Autoantibodies Against Pancreatic Beta Cells in Children with Type 1 Diabetes Mellitus
کودکان
children
گزارش کوتاه
Brief Report
<span style="font-size:16px;"><span style="line-height:2;"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">سابقه</span></span></span></span><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt"> و هدف:</span></span></span></span> <span lang="AR-SA"><span b="" style="font-family:" zar="">اتوآنتی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">بادی انتقالدهنده روی 8</span></span><span dir="LTR"> (ZnT8A) </span><span lang="AR-SA"><span b="" style="font-family:" zar="">اخیراً بهعنوان یک آنتی بادی جدید در دیابت قندی نوع یک شناسایی شد و مثبت بودن آن با شروع زودرس این بیماری مرتبط است. لذا این مطالعه با هدف تعیین فراوانی اتوآنتی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">بادی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">های مربوط به دیابت قندی نوع یک خصوصا </span></span><span dir="LTR">ZnT8A</span><span lang="AR-SA"><span b="" style="font-family:" zar=""> به عنوان یک آنتی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">بادی جدیدتر در کودکان 1 تا 18 سال مراجعهکننده به بیمارستان کودکان امیرکلا<b> </b>انجام گرفت.</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:#0e101a"></span></span></span></span></span></span><br>
<span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">مواد و روش</span></span></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt"></span></span></span></span><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.1pt">ها:</span></span></span></span> <span lang="AR-SA"><span b="" style="font-family:" zar="">در این پژوهش توصیفی تحلیلی، 80 کودک زیر 18 سال مبتلا به دیابت قندی نوع یک مراجعه</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">کننده به بیمارستان کودکان امیرکلا، بابل، ایران در طی سال</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">های 1392 تا 1400، وارد مطالعه شدند. دیابت کودکان براساس معیارهای انجمن دیابت آمریکا و با ویزیت فوق تخصص غدد کودکان تشخیص داده شد. آنتی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">بادی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">های مربوط به دیابت قندی نوع یک شامل 65 گلوتامیک دکربوکسیلاز </span></span><span dir="LTR">(anti-GAD)</span><span lang="AR-SA"><span b="" style="font-family:" zar="">، پروتئین تیروزین فسفاتاز (</span></span><span dir="LTR">IA-2A</span><span lang="AR-SA"><span b="" style="font-family:" zar="">)، اتوآنتی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">بادی ضد سلولهای جزیره (</span></span><span dir="LTR">ICA</span><span lang="AR-SA"><span b="" style="font-family:" zar="">)، اتوآنتیبادی انسولین (</span></span><span dir="LTR">IAA</span><span lang="AR-SA"><span b="" style="font-family:" zar="">) و انتقالدهنده روی 8</span></span><span dir="LTR"> (ZnT8A) </span><span lang="AR-SA"><span b="" style="font-family:" zar="">در زمان تشخیص بیماری، از نمونه خون و به روش الایزا سنجش شد. دادهها با استفاده از آزمون</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">های تی تست و کای اسکوئر و تست دقیق فیشر آنالیز شدند. سطح معنیداری در این مطالعه 0/05</span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">></span></span><span dir="LTR">P</span><span lang="AR-SA"><span b="" style="font-family:" zar=""> در نظر گرفته شد.</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span></span></span></span><br>
<span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">یافته</span></span></span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">ها:</span></span></span></span> <span lang="AR-SA"><span b="" style="font-family:" zar="">در این مطالعه 80 کودک با میانگین سنی 3/6</span></span><span lang="AR-SA">±</span><span lang="AR-SA"><span b="" style="font-family:" zar="">7/9 سال (57 درصد دختر و 43 درصد پسر) مورد بررسی قرار گرفتند. سطح </span></span><span dir="LTR">GADA</span><span lang="AR-SA"><span b="" style="font-family:" zar=""> در نمونه</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">های مورد مطالعه 65/2 درصد، </span></span><span dir="LTR">IA</span><b><span dir="LTR">-</span></b><span dir="LTR">2A</span><span lang="AR-SA"><span b="" style="font-family:" zar=""> 58/8 درصد، </span></span><span dir="LTR">ZnT8A</span><span lang="AR-SA"><span b="" style="font-family:" zar=""> 56/3 درصد و </span></span><span dir="LTR">ICA</span><span lang="AR-SA"><span b="" style="font-family:" zar=""> 47/5 درصد و </span></span><span dir="LTR">IAA</span><span lang="AR-SA"><span b="" style="font-family:" zar=""> 6/3 درصد بود.</span></span><span lang="FA"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span></span></span></span><br>
<span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA"><span b="" koodak="" style="font-family:"><span style="color:black"><span style="letter-spacing:-.2pt">استنتاج:</span></span></span></span> <span lang="AR-SA"><span b="" style="font-family:" zar="">در مطالعه حاضر، 93/8 درصد بیماران دیابتی، اتوآنتی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">بادی مثبت بودند که نشان می</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">دهد با اندازه</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">گیری سطح آنتی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">بادی</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">های پانکراس، دیابت نوع یک در بیش از 90 درصد بیماران تایید می</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">شود. همچنین با اندازه</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">گیری </span></span><span dir="LTR">ZnT8A</span><span lang="AR-SA"><span b="" style="font-family:" zar="">، درصد موارد دیابت نوع یک ایدیوپاتیک نیز کاهش می</span></span><span b="" lang="FA" style="font-family:" zar=""><span style="color:black"></span></span><span lang="AR-SA"><span b="" style="font-family:" zar="">یابد.</span></span><span lang="AR-SA"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.2pt"></span></span></span></span></span></span></span><br>
<span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="AR-SA"><span b="" style="font-family:" zar=""><span style="color:black"></span></span></span></span></span></span></span></span><br>
<span style="font-size:16px;"><span style="line-height:2;"><span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:"><span style="letter-spacing:-.2pt">Background and purpose:</span></span></b> Zinc transporter autoantibody 8 (ZnT8A) was recently identified as a novel antibody antigen in type 1 diabetes mellitus, and its positivity is associated with early onset of the disease. So the present study was conducted to determine the prevalence of autoantibodies related to type 1 diabetes mellitus, especially ZnT8A as a newer antibody in children from 1 to 18 years of age referred to Amirkola Children's Hospital.<span style="line-height:130%"></span></span><br>
<span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:">Materials and methods:</span></b><b> </b>In this descriptive and analytical study, 80 children under 18 years of age with type 1 diabetes referred to Amirkola Children's Hospital, Babol, Iran during the years 2013 to 2021 were included in the study. Pediatric diabetes was diagnosed based on the criteria of the American Diabetes Association and with a visit to a pediatric endocrinologist. Antibodies related to type 1 diabetes including 65 glutamic decarboxylase (anti-GAD), protein tyrosine phosphatase (IA-2A), anti-islet cell autoantibodies (ICA), insulin autoantibodies (IAA), and zinc transporter 8 (ZnT8A) was measured from their blood samples at the time of disease diagnosis by ELISA method. Data were analyzed using t-test, chi-square, and Fisher's exact test. The significance level in this study was considered as p<0.05.<span style="line-height:130%"></span></span><br>
<span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:">Results:</span></b><b> </b>Samples were 80 children with an average age of 7.9±3.6 years (57% girls and 43% boys). The level of GADA in the studied samples was 65.2%, IA-2A 58.8%, ZnT8A 56.3%, ICA 47.5%, and IAA 6.3%.<span lang="EN"><span style="line-height:130%"></span></span></span><br>
<span style="vertical-align:top"><span new="" roman="" style="font-family:" times=""><b><span arial="" style="font-family:">Conclusion:</span></b> 93.8% of diabetic patients were autoantibody positive, which shows that by measuring the level of pancreatic antibodies, type 1 diabetes is confirmed in more than 90% of patients. Also, by measuring newer antibodies such as ZnT8A, the percentage of idiopathic type 1 diabetes cases also decreases.<i><span style="color:black"></span></i></span></span></span></span><br>
اتوآنتیبادیهای ضد سلولهای جزیره, دیابت ملیتوس نوع 1, کودکان
Islet cell autoantibodies, type 1 diabetes mellitus, children
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160
http://jmums.mazums.ac.ir/browse.php?a_code=A-10-12771-3&slc_lang=fa&sid=1
Zahra
Panahivand
زهرا
پناهی وند
Zahrapanahi6193@gmail.com