Journal of Korean medical science
Prevalence, Diagnostic Role, and Clinical Features of Zinc Transporter 8 Autoantibody in Korean Children and Adolescents With Diabetes Mellitus
By Shin S, Woo HA, Lee H and 6 others.
Abstract
Background
Zinc transporter 8 autoantibodies (ZnT8As) are biomarkers of type 1 diabetes mellitus (T1DM). We evaluated its prevalence, diagnostic utility, and clinical characteristics in Korean children and adolescents with diabetes.
Methods
ZnT8A levels were measured in 288 patients with diabetes mellitus (DM) (aged < 19 years, diagnosed with DM between 2019 and 2025) at two tertiary hospitals and in 100 healthy controls (19-39 years). The ZnT8A positivity cutoff was ≥ 15 U/mL. Clinical features were compared between ZnT8A-positive and ZnT8A-negative patients across diabetes subtypes.
Results
The study included 178 patients with T1DM (60.4%, mean age 9.7 years), 110 patients with type 2 diabetes mellitus (T2DM) (39.6%, mean age 14.1 years), and 100 controls. The positivity rates in patients with T1DM, T2DM, and controls were 94.9%, 1.8%, and 5.0% for any islet autoantibodies; 74.7%, 0%, and 0% for ZnT8A; 74.7%, 0%, and 5.0% for autoantibody to tyrosine phosphatase-related islet antigen 2 (IA-2A); 62.4%, 1.8%, and 0% for autoantibody to glutamic acid decarboxylase (GADA); and 23.6%, 0%, and 0% for insulin autoantibody (IAA), respectively. Among patients with T1DM, the proportions of individuals who were positive for only a single autoantibody were as follows: 2.8% for ZnT8A alone, 4.5% for IA-2A alone, 3.9% for GADA alone, and 2.2% for IAA alone. ZnT8A-positive T1DM patients were younger and more often prepubertal compared to ZnT8A-negative T1DM patients.