Abstrakt

Assessment of serum levels of immunoglobulin A and immunoglobulin G in children newly diagnosed with type 1 diabetes mellitus (T1D).

Basma Abdel-Moez Ali, Madiha Abdalla Sayed, Hend Mohammed Moness, Mahmoud Mohammed Mahmoud

Introduction: T1D is the most common chronic metabolic autoimmune disease. Histological analysis of the pancreas from patients with T1D shows immunological activity limited to insulin-containing islets, including infiltration by activated lymphocytes, antibodies and components of the complement system. These histological findings are consistent with T1D being an immune-mediated disease. Aim of the study: To evaluate and compare serum levels of Immunoglobulin A (IgA) and Immunoglobulin G (IgG) in children newly diagnosed with T1D, children with duration of T1D more than 5 years and normal control children. Moreover, studying different correlations between them and some clinical and laboratory parameters. Subjects and methods: This study included two groups; Group I: 70 patients with T1D who subdivided into: Group Ia 35 patients (newly diagnosed), Group Ib; 35 patients with duration >5 years and Group II included 30 apparently healthy children as a control group, age and sex matched to diseased group. The studied groups were subjected to thorough history taking, clinical examination and laboratory investigations including random blood glucose (RBG), glycosylated Hemoglobin (HbA1c%) and serum levels of IgA and IgG. Results: Serum IgA levels were insignificantly higher among newly diagnosed patients and significantly higher among old diabetics than the control subjects where (P=0.05 & P=0.001), respectively. Concerning IgG levels, both newly diagnosed and old diabetics patients had significantly lower levels than the control subjects where (P=0.05 & P=0.008), respectively. Newly diagnosed diabetic children had significantly lower serum levels of IgA and IgG than old diabetic where (P=0.02, 0.001), respectively. In newly diagnosed diabetic children, IgA levels had insignificant fair positive correlation with the dose of insulin and IgG levels had insignificant fair positive correlation with BMI and a significant fair positive correlation with waist circumference (WC). In old diabetics, there was insignificant fair positive correlation between IgA levels with HbA1c% and between IgG levels with duration of T1D. Conclusion: Alterations of serum IgA and IgG levels in newly diagnosed as well as in old diabetic children, may reflect the autoimmune nature of T1D. In addition, there were differences between newly diagnosed and old diabetic children as regard serum IgA and IgG levels, which may suggest that the duration of T1D affects their levels.