ZnT8 autoantibody prevalence is low in youth with type 2 diabetes and associated with higher insulin sensitivity, lower insulin secretion, and lower disposition index.

Abstract

Aim:

ZnT8 autoantibody positivity (ZnT8+) is associated with risk for type 1 diabetes and with metabolic complications in adults. Our aim was to assess prevalence of ZnT8 + in the Treatment of T2D in Adolescents and Youth (TODAY) cohort and describe associated phenotypic outcomes.

Methods:

TODAY participants were 13.98 ± 2.03 years with a confirmed diagnosis of T2D, BMI percentile of 97.69 ± 3.32 (64% female), and GAD- and IA2- at baseline. ZnT8 autoantibodies were measured at baseline and end of study.

Results:

3 of 687 participants (0.29%) were ZnT8 + and there was one conversion (0.15%) from ZnT8- to ZnT8 + during the study. ZnT8A + individuals had higher HbA1c, HDL and LDL cholesterol, and IL-1β concentrations, and lower BMI, IL-6, and triglyceride concentrations compared to the TODAY cohort and ZnT8A- individuals. They also had higher insulin sensitivity with lower insulin secretion and disposition index, metabolically resembling T1D. All ZnT8 + participants experienced loss of glycemic control on randomized treatment, but exhibited lower rates of diabetic complications than other groups.

Conclusion:

Given the low rate of complications in ZnT8 + individuals, ZnT8 likely does not impact the clinical course of the disease in this population.

• Authors: Janine Higgins, Philip Zeitler, Kimberly L Drews, Silva Arslanian, Kenneth Copeland, Robin Goland, Georgeanna Klingensmith, Terri H Lipman, Sherida Tollefsen, TODAY Study Group
• Journal: Journal of clinical & translational endocrinology (J Clin Transl Endocrinol) Vol. 29 Pg. 100300 (Sep 2022) ISSN: 2214-6237 [Electronic] Netherlands
• PMID: 35601597 (Publication Type: Journal Article)
• Copyright: © 2022 The Author(s).