Islet Autoantibodies in Adult With Pituitary and Ovarian Autoimmunity: Implications for Type 1 Diabetes Screening

Type 1 diabetes is a chronic autoimmune disease characterised by progressive pancreatic β-cell destruction and the early appearance of islet autoantibodies (islet-AAb) during the pre-symptomatic phases. Given the growing interest in screening and prevention of type 1 diabetes, this study aimed to assess the prevalence of pancreatic autoimmunity in adults with other organ-specific autoantibodies in order to identify potential target populations for screening programs.

Adults previously tested for autoantibodies against specific endocrine glands and/or gastric parietal cells by indirect immunofluorescence were divided into two groups (Autoimmunity group and Control group), according to the presence of at least one organ-specific autoantibody. Stored serum samples from all participants were re-evaluated for islet-AAb and comparisons were performed between groups and, within the Autoimmunity group (Group A), across different patterns of organ-specific autoimmunity.

Positivity for at least one islet-AAb was significantly higher in Group A than in Control Group (40.3% vs. 21.0%; p = 0.007). Double and triple islet-AAb positivity were less common overall, but occurred more frequently in Group A. Moreover, in Group A, a significantly higher prevalence of multiple positivity (≥ 2 islet-AAb) was observed in subjects with ovarian autoimmunity and in those with combined pituitary and ovarian autoimmunity than in those with other endocrine autoimmune involvement.

Adults with specific autoimmunity disorders, particularly those affecting ovarian and/or pituitary glands, have a higher prevalence of pancreatic autoimmunity. These subjects may benefit from targeted screening to identify the pre-symptomatic stage of T1D and potentially delay progression to clinical disease.