| Objective:Type 1 diabetes mellitus is a kind of autoimmune disease caused by genetic factors and environmental factors,which are mediated by T cells and produce corresponding immune response to special ? cell autoantigen,thereby destroying islet cells and leading to insulin deficiency.However,patients with type 1 diabetes have an immune response that is not limited to attack islet cells.Other organs are also attacked to produce immune damage.When the immune damage involves more than two endocrine glands,they develop into autoimmune polyendocrine syndromes.The aim of this study was to test the levels of pancreas,thyroid,adrenal,parathyroid and gonadal organ-specific antibodies in type 1 diabetes patients and to explore the incidence of development to APS in type 1 diabetes patients.Methods:Forty-four patients with type 1 diabetes mellitus were selected from the Department of Endocrinology,80 patients with no autoimmune disease and no stress state were selected from physical examination center.After obtaining the informed consent,fill in the questionnaire and take the fasting blood.The ELISA and electrochemiluminescence were used to detect the levels of antibodies related to islets,thyroid,adrenal,parathyroid and gonads in both groups.All statistical analyses were performed using SPSS21.0 software.Results:The antibody levels of gonadal,adrenal gland and parathyroid gland of the two groups were significantly different(P <0.001).Further qualitative analysis showed that were 31(70.45%)patients with pancreas antibodies positive and 26(59.09%)patients with other endocrine gland antibodies positive,There were 23 patients(52.27%)with TPOAb positive,9(20.45%)with TGAb positive,9(20.45%)with TRAb positive,2(4.55%)with NALP5 Ab positive and P450 scc Ab positive in 3 patients(6.82%),but no 21-OHAb,17-?-OHAb and Ca SRAb positive patients were found.19 of 44(43.18%)patients with type 1 diabetes mellitus had clinical manifestations of autoimmune diseases of other endocrine glands.Further analysis showed that a positive rate of islet antibody in male patients was higher than that in female(71.43% vs 33.33%,P = 0.041).Patients with type 1 diabetes who were onset age? 17 years had a significantly higher positive rate of combined TPOAb,TGAb and two thyroid antibodies(72.73% vs 31.82%,P = 0.007,36.36% vs 4.55%,P = 0.025,45.45% vs 4.55%,P = 0.005).There was a significant increase in the proportion of patients with age< 28.5 years combined with one type of islet antibody(28.57% vs 60.87%,P = 0.032),while those with age? 28.5 years had TGAb positive and two thyroid antibody positive rates(38.1% vs 4.35%,P = 0.016,42.86% vs 8.7%,P = 0.023).Patients with GADAb positive had a significant higher risk of having TPOAb positive(68.97% vs 20%,P = 0.006).In patients with two positive islet autoantibody,the positive rate of the combined non-islet antibody increased more than that of islet autoantibody(33.33% vs 75%,P = 0.041).Conclusion:Patients with type 1 diabetes,especially those with GADAb positive or with more than two types of islet antibody positive patients,have a significantly increased incidence of APS than in normal people.Among them,APS IIIA is the most common,and the incidence of thyroid autoimmune diseases is highest.As the patient ages and the duration of the disease increases,the risk of developing APS increases.The thyroid hormone level should be routinely measured at the time of initial diagnosis and followed up for a long period of time to alert to the occurrence of other symptoms of endocrine gland dysfunction for early detection,early treatment,and improved prognosis. |
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