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Clinical Features and HLA Genetics Differ in Children at Type 1 Diabetes Onset by Hispanic Ethnicity

Kagan E Karakus1, Theodore Fleury1, Erin E Baschal1

  • 1Barbara Davis Center for Diabetes, University of Colorado, Aurora, CO 80045, USA.

The Journal of Clinical Endocrinology and Metabolism
|September 4, 2024
PubMed

Insights

Hispanic White children with type 1 diabetes are diagnosed younger and have higher rates of diabetic ketoacidosis. They also show a significantly higher prevalence of the specific human leukocyte antigen (HLA) DR4-DQ8 genetic marker.

Area of Science:

  • Pediatric Endocrinology
  • Immunogenetics
  • Diabetes Research

Background:

  • Type 1 diabetes (T1D) incidence is rising in children, particularly among Hispanic White (HW) populations.
  • Understanding ethnic disparities in T1D presentation is crucial for targeted interventions.

Purpose of the Study:

  • To compare clinical, immunologic, and genetic factors in HW and non-Hispanic White (NHW) children at T1D diagnosis.
  • To identify potential risk factors and differences in disease presentation between ethnic groups.

Main Methods:

  • An observational, single-center study included 1297 children (≤20 years) diagnosed with T1D.
  • Patients were categorized by Hispanic ethnicity and tested for islet autoantibodies and human leukocyte antigen (HLA) type.

Main Results:

  • HW children were diagnosed at a younger age (10.2 vs 11.1 years) and presented more frequently with diabetic ketoacidosis (62.4% vs 51.9%) compared to NHW children.
  • No significant differences were observed in sex, A1c, or autoantibody profiles.
  • A higher prevalence of the HLA-DR4-DQ8 haplotype was found in HW children (79.1%) versus NHW children (60.1%).

Conclusions:

  • HW children with T1D exhibit a high frequency of the HLA-DR4-DQ8 haplotype.
  • This genetic marker can aid in identifying HW children at higher risk for T1D.
  • Targeted immune monitoring and early intervention strategies may reduce diabetic ketoacidosis and potentially prevent T1D onset in this population.
Abstract

Keywords:
HLA geneticsHispanicdiabetic ketoacidosisethnicityislet autoantibodiestype 1 diabetes

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