OBJECTIVE

This study assessed the relationship between autoantibodies against zinc transporter

8 (ZnT8A) and disease characteristics at diagnosis of type 1 diabetes and

during the first 2 years.

RESEARCH DESIGN AND METHODS

Children, younger than 15 years of age (n = 723) who were newly diagnosed with

diabetes, were analyzed for ZnT8A, other diabetes-associated autoantibodies,

HLA DR-DQ alleles, and metabolic status, which was monitored by pH, plasma

glucose, and occurrence of ketoacidosis at diagnosis and through follow-up of

C-peptide concentrations, exogenous insulin dose, and glycosylated hemoglobin

for 2 years after the diagnosis.

RESULTS

ZnT8A positivity was detected in 530 children (73%). Positivity for ZnT8A was

associated with older age (median 8.9 vs. 8.2 years, P = 0.002) and more frequent

ketoacidosis (24% vs. 15%, P = 0.013). Children carrying the HLA DR3 allele were

less often ZnT8A positive (66% vs. 77%, P = 0.002) than others. ZnT8A-positive

children had lower serum C-peptide concentrations (P = 0.008) and higher insulin

doses (P = 0.012) over time than their ZnT8A-negative peers.

CONCLUSIONS

Positivity for ZnT8A at diagnosis seems to reflect a more aggressive disease process

before and after diagnosis.