This study aims to evaluate the risk of islet autoimmunity in patients with autoimmune thyroid disease (AITD), describe related clinical and laboratory characteristics, and explore the development of a risk assessment model based on clinical, laboratory, and genetic markers. Adults aged 18-60 years with confirmed AITD will undergo baseline assessment including demographic data, anthropometric measures, lifestyle factors, medical history, thyroid-related clinical information, thyroid function, and thyroid antibody testing. A baseline blood sample will be collected for measurement of islet autoantibodies (GADA, IA-2A, ZnT8A, and IAA). Participants with positive islet autoantibodies will undergo further evaluation of glucose metabolism and beta-cell function, including HbA1c, OGTT, insulin, and C-peptide testing. Genome-wide genetic data will be used to construct a type 1 diabetes-related genetic risk score, and additional HLA genotyping may be performed in autoantibody-positive participants. The study will assess the prevalence and profile of islet autoantibodies in AITD and identify clinical, laboratory, and genetic factors associated with islet autoantibody positivity.
Study Type
OBSERVATIONAL
Enrollment
834
This is an observational study. Eligible participants are patients aged 18-60 years with autoimmune thyroid disease (AITD), including Hashimoto's thyroiditis and Graves' disease, diagnosed by an endocrinology specialist. At baseline, demographic information, physical measurements, lifestyle factors, AITD-related clinical data, thyroid function, and thyroid autoantibody levels will be collected. Blood samples will also be obtained for measurement of islet autoantibodies (GADA, IA-2A, ZnT8A, and IAA) and their titers. Participants who test positive for islet autoantibodies will, within 2 months, undergo further evaluation including HbA1c testing, OGTT with insulin and C-peptide assessment, and HLA genotyping. A type 1 diabetes-related genetic risk score (GRS) will be constructed for all participants for exploratory analysis. No therapeutic intervention will be administered in this study.
Genetic Risk Score (GRS) Characteristics in AITD Patients With Islet Autoantibody Positivity
Describe and analyze the type 1 diabetes-specific composite genetic risk score (GRS) among participants with islet autoantibody positivity. Evaluate the association strength between high genetic risk (e.g., GRS in the upper quartile of the study population) and islet autoantibody positivity, expressed as odds ratios (ORs).
Time frame: Baseline
HLA Genetic Characteristics of AITD Participants with Islet Autoantibody Positivity
Conduct HLA genotyping (e.g., HLA-DR, HLA-DQ) among participants who are positive for islet autoantibodies to describe the distribution of their alleles and haplotypes. Perform exploratory analyses to determine whether specific HLA alleles or haplotypes associated with high risk of type 1 diabetes are present among antibody-positive individuals.
Time frame: Enrollment within 8-12 weeks
Association Analysis Between Islet Autoantibody Positivity and Clinical/Demographic Risk Factors in AITD Participants
Using multivariable regression analysis, identify non-genetic factors independently associated with islet autoantibody positivity and report adjusted odds ratios (aORs) and confidence intervals (CIs). Proposed risk factors include: - Demographics: age, sex, BMI, waist-to-hip ratio, smoking history, alcohol consumption history; - Medical history, personal history, family history: family history of diabetes; history of other autoimmune diseases in first-degree relatives, such as autoimmune thyroid disease, rheumatoid arthritis, systemic lupus erythematosus; presence of other confirmed autoimmun
Time frame: Baseline
Antibody titers in IAb-positive participants:
Standardized immunoassay based on a single blood sample, reference value range for each antibody: GADA (reference value \<10 IU/mL); IAA (reference value \<1 COI); IA-2A (reference value \< 10 IU/mL); ZnT8A (reference value \<10 AU/mL)
Time frame: Baseline
Positivity rate of islet autoantibodies in AITD patients.
Standardized immunoassay based on a single blood sample, reference value range for each antibody: GADA (reference value \<10 IU/mL); IAA (reference value \<1 COI); IA-2A (reference value \< 10 IU/mL); ZnT8A (reference value \<10 AU/mL)
Time frame: Baseline
Distribution of islet autoantibody profiles.
Standardized immunoassay based on a single blood sample, reference value range for each antibody: GADA (reference value \<10 IU/mL); IAA (reference value \<1 COI); IA-2A (reference value \< 10 IU/mL); ZnT8A (reference value \<10 AU/mL)
Time frame: Baseline
β-cell Function in AITD Patients With Islet Autoantibody Positivity
Describe and analyze fasting C-peptide levels and/or the area under the C-peptide curve (AUC-C-peptide) derived from the OGTT among participants with islet autoantibody positivity.
Time frame: Enrollment within 8-12 weeks
Glycemic Metabolic Characteristics of AITD Patients With Islet Autoantibody Positivity
Based on OGTT and WHO diagnostic criteria, describe and analyze the proportions of participants with normal glucose regulation and abnormal glucose metabolism (including impaired fasting glucose and impaired glucose tolerance). Describe the glycated hemoglobin (HbA1c) levels of individuals with islet autoantibody positivity.
Time frame: Enrollment within 8-12 weeks
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