Reduction in White Blood Cell, Neutrophil and Red Blood Cell counts Related to Gender, HLA and Islet Autoantibodies in Swedish TEDDY Children at Increased Risk for Type 1 Diabetes

Reduction in White Blood Cell, Neutrophil and Red Blood Cell counts Related to Gender, HLA and Islet Autoantibodies in Swedish TEDDY Children at Increased Risk for Type 1 Diabetes

Falastin Salami, Hye-Seung Lee, Eva Freyhult, Helena Elding Larsson, Åke Lernmark and Carina Törn, the TEDDY study group

Diabetes 2018 Aug; db180355

Islet autoantibodies (IA) precede the clinical onset of type 1 diabetes (T1D), however, the knowledge is limited whether the prodrome affects complete blood counts (CBC) in 4-12 years old children with increased genetic risk for T1D. The aim of this study was to test if CBC was altered in 4-12 years old children without (n=376) or with one or several IA against either insulin, GAD65 or IA-2 (n=72). CBC was analyzed during longitudinal follow up in 448 Swedish children enrolled in The Environmental Determinants of Diabetes in the Young (TEDDY) study. A linear mixed effects model was used to assess potential association between IA and CBC measurements over time. The white blood cell and neutrophil counts were reduced in children with IA, primarily in boys. In contrast, girls had lower levels of hemoglobin and hematocrit. Positivity for multiple IA showed the lowest counts in white blood cells and neutrophils in boys and red blood cells, hemoglobin and hematocrit in girls. These associations were primarily observed in children with the HLA-DR3-DQ2/DR4-DQ8 genotype.

It is concluded that the reduction in neutrophils and red blood cells in children with multiple IA and HLA-DR3-DQ2/DR4-DQ8 genotype, may signal a gender-dependent islet autoimmunity detected in longitudinal CBC.