Could ZnT8 antibodies replace ICA, GAD, IA2 and insulin antibodies in the diagnosis of type 1 diabetes?

BACKGROUND: The zinc transporter 8 (ZnT8) is an islet ß-cell secretory granule membrane protein coded by the SLC30A8 gene, identified as a novel autoantigen in human type 1 diabetes (T1D). As no data of ZnT8ab in Algerian patients have been reported, we aim to evaluate the prevalence of ZnT8ab in young Algerians with T1D and determine whether ZnT8ab could be a better diagnostic tool to replace the other conventional autoantibodies detected in patients with type 1 diabetes. For this purpose, we evaluated the prevalence of islets cells antibodies (ICA), glutamic acid decarboxylase (GAD), islet antigen type 2 (IA2), insulin (IA) autoantibodies (ab) and for the first time in Algeria, the zinc transporter 8 (ZnT8) in young Algerian patients with type 1 diabetes. PATIENTS AND METHODS: In our cross-sectional study, 160 patients between 1 and 35 years old, diagnosed with type 1 diabetes were enrolled. ICAab was analyzed by indirect immunofluorescence (IIF), GADab, IA2ab, IAab and ZnT8ab were analyzed by ELISA, fasting blood glucose was performed by enzymatic method (glucose-oxidase) and HbA1c by turbid metric method. RESULTS: Our cohort was composed with 74 males and 86 females (OR=1.16); the mean of age was 14.09 [1-35] years old and the median diabetes duration was 4.10 [1-18] years. Our cohort had a mean of HbA1c of 9.22 [5.40-15]%, the mean of birth weight was 3360.52 [2200-4800]g; the mean of BMI was 19.30 [16.04-22.46]kg/m2. Out of 160 patients, 44 (27.5%) were under mother breastfeeding and 116/160 (72.5%) were under artificial feeding. One antibody, at least, was found in 94.38% and the ZnT8ab was significantly more positive in females (70.3%) than in males (10.7%) (***P=8.033×10-15). The concentration of ZnT8ab was higher in females than in males (females=122.25UI/mL versus males=51.38UI/mL; *P=0.03); ICAab, GADab and ZnT8ab were more present in patients with consanguineous parents (***P=0.0002, *P=0.019 and *P=0.03; respectively) CONCLUSION: Our study on ZnT8ab in T1D is the first in the Maghreb region and we observed a prevalence of 46.25%. The positivity of ZnT8ab enabled us to classify in T1DA 50% of diabetics with obvious T1D phenotype and negative routine autoantibodies, thus ZnT8ab is a good tool for differential diagnosis of type 1 diabetes. According to our results, a simultaneous analysis for ZnT8 and IA2 autoantibodies can be a better and efficient diagnosis of type 1A diabetes from the beginning of the disease.

[Primary evaluation of the behaviour eating disorder in obese and type 2 diabetic Algerian subjects]. / Evaluation primaire des troubles du comportement alimentaire chez le sujet obèse et le patient diabétique de type 2 algérien.

BACKGROUND: Glucose imbalance in type 2 diabetes and massive weight gain in obese subjects are disorders that are correlated with Behaviour Eating Disorder (BED), leading to a hypercaloric, sweet and fat oriented diet. AIM: This study examined how BED such as dietary restriction, disinhibition, and hunger, are assessed by Three Factor Eating Questionnaire (TFEQ) and Dutch Eating Behaviour Questionnaire (DEBQ). METHODS: In the present investigation these factors were studied in a sample of Algerian population composed of 30 obese subjects, 70 type 2 diabetic patients and 30 healthy subjects. 51 questions or items were used for the TFEQ test and 33 questions for the DEBQ test. RESULTS: Multivariate analysis showed that restriction and disinhibition were significantly associated with obesity and diabetes pathogenesis. Compared to healthy subjects, obese patients showed a significant hyperphagic BED type (disinhibition and hunger disorders). These BED are associated with psycho-sensory disorders as characterized by externality and emotivity. Conversely, the diabetic patient showed both hypophagic and hyperphagic BED. CONCLUSION: In this study, the role of BED in obesity genesis and in glycaemia dysregulation of the diabetes pathology seems to be confirmed. An early identification of these disorders deserves further investigation in a broad Algerian population in order to treat them.

[Metabolic syndrome and hormonal interaction in obese and type 2 diabetic Algerian subject: the behavior eating disorder impact]. / Syndrome métabolique et interaction hormonale chez le sujet obèse et le patient diabétique de type 2 algérien: impact des troubles du comportement alimentaire.

BACKGROUND: These twenty last years, the metabolic syndrome was accused in various human pathologies including android obesity and type 2 diabetes. In obesity, increased body weight is frequently associated with excessive caloric food and sedentary activities. The Behaviour Eating Disorders (BED) is involved in over-consumption alimentary. In Algeria, we observed increasingly deviations in life-style alimentary, from the Mediterranean-Cretan model to American fast-food model. AIM: To study interactions between the BED, hormonal secretions and metabolic syndrome parameters. METHODS: The present study was undertaken on Algerian population cohorts composed of 30 obese subjects, 70 type 2 diabetic patients and 30 healthy subjects. The BED was evaluated by TFEQ and DEBQ tests. Anthropometric parameters (waist circumference, IMC), metabolic parameters (glucose, triglycerides, HDL-C, LDL-C) and hormones (insulin, peptide C, ACTH, cortisol, GH) were determinates by biometrics, spectrophotometry and radioimmunology methods, respectively. RESULTS: Multivariate analyses showed the high correlation between the BED and the metabolic syndrome, particularly a critical insulinoresistance state (IR). This IR generates in periphery a whole of metabolic disorders: dyslipidemia, hyperglycemia and hypertrophy of adipose tissue. In diabetic and obese patients, cortisol, ACTH and GH secretions are insidiously altered and to lead metabolic disorders. CONCLUSION: In this study, the role of the BED in obesity and diabetes genesis seems to be confirmed. In response to nutritional stress, the BED generates a hyperactivity of endocrine pancreas, adrenal gland, and pituitary gland. It appeared that Algerian population is not adapted to fast-food American model.