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ATP4A autoimmunity in pediatric patients with type 1 diabetes and its relationship to blood count, iron metabolism, and vitamin B12
Author(s) -
Chobot Agata,
Rusak Ewa,
Wenzlau Janet,
Davidson Howard,
Adamczyk Piotr,
Krzywicka Agnieszka,
Mazur Bogdan,
Polańska Joanna,
Rewers Marian
Publication year - 2018
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12528
Subject(s) - medicine , autoimmunity , vitamin b12 , diabetes mellitus , type 1 diabetes , type 2 diabetes , immunology , endocrinology , antibody
Objective We aimed to assess the prevalence of autoantibodies against the 4A subunit of the gastric proton pump ( ATP4A ) in pediatric type 1 diabetes ( T1D ) patients and explore the relationship between ATP4A positivity and blood cell count, iron turnover, and vitamin B12 concentration. Subjects The study included 94 (59% female) T1D children (aged 12.5 ± 4.1 years, T1D duration 4.2 ± 3.6 years, HbA1c 7.3 ± 1.5% (57 ± 12.6 mmol/mol) with no other autoimmune diseases. Methods ATP4A antibodies were measured in T1D patients using a radioimmunoprecipitation assay. Blood cell count, iron concentration, total iron binding capacity, ferritin, transferrin, hepcidin, and vitamin B12 concentration were measured in all the study participants. Results A total of 16 (17%) children were ATP4A positive. Serum concentrations of ferritin were significantly lower in ATP4A positive than in antibody negative subjects ( P = .034). Overall the levels of ATP4A antibodies ( ATP4A Index) correlated positively with the age at T1D diagnosis ( r = 0.228, P = .026) and negatively with ferritin levels ( r = −0.215, P = .037). In ATP4A positive patients, the ATP4A Index correlated positively with age at diagnosis ( r = 0.544, P = .032) and negatively with vitamin B12 levels ( r = −0.685, P = .004). Conclusions ATP4A antibodies were present in a significant proportion of children with T1D . Higher ATP4A levels in T1D children are associated with lower, yet still fitting within the normal range, levels of vitamin B12 , and ferritin. Routine screening of T1D children for gastric autoimmunity ( ATP4A ) should be considered with follow‐up of those positive for vitamin B12 and iron deficiency.