Higher prevalence of islet-related autoantibody positivity in obese Chinese children and adolescents

Abstract Objectives The prevalence of type 1 diabetes mellitus has increased along with rising incidence of childhood obesity. This study aims to investigate the prevalence of islet-related autoantibodies among obese children in China. Methods The study enrolled patients with moderate to severe obesity aged under 18 years who were admitted between 1 January 2019 and 30 April 2024. Glutamic acid decarboxylase antibody, insulin autoantibody, islet cell autoantibody, zinc transporter 8 autoantibody, and insulinoma-associated protein 2 autoantibody, were measured through chemiluminescent immunoassay. A comparative analysis was conducted of the indicators for glycemic metabolism among the three subgroups, defined according to their autoantibody status. Results Among the 1826 obese children included, 10.9 % were positive for at least one autoantibody, significantly higher than the normal-weight population (1.86 %, p<0.001). Positive results for two autoantibodies were observed in 1.9 % of obese children, statistically higher than in the general population (0.39 %, p<0.01). The HbA 1c level of the two antibody positive groups was statistically higher than that of the antibody negative group (5.8 % vs. 5.6 %, p=0.012). No statistical difference was observed among the three groups regarding anthropometric indicators, biochemical parameters and indicators of glucose metabolism. Conclusions The prevalence of islet-related autoantibodies is higher in obese children, which may contribute to an increasing susceptibility to Type 1 Diabetes Mellitus. The study underscores the necessity for screening in obese children, as this may facilitate early intervention for T1DM.