Objective  To explore the relationships between serum zinc transporter 8 autoantibody (ZnT8A), glutamic acid decarboxylase antibody (GADA), protein tyrosine phosphatase antibody (IA-2A) and renal damage in children with type 1 diabetes mellitus.

  Methods  A total of 123 children with type 1 diabetes mellitus (study group) and 105 healthy children (control group) at same period were selected as study subjects, and the levels of serum ZnT8A, GADA and IA-2A were detected and compared between the two groups. The renal function of the children in the study group was evaluated, and the children were divided into complicated group and the non-complicated group according to the concurrent conditions of renal damage, and the positive rates of serum ZnT8A, GADA and IA-2A were compared between the complicated group and the non-complicated group. The relationships between the positive of serum ZnT8A, GADA, IA-2A and renal damage in children with type 1 diabetes mellitus were analyzed by Logistic multiple regression analysis.

  Results  The positive rates of ZnT8A, GADA and IA-2A in the study group were 41.46%, 60.98% and 45.53%, respectively, and were significantly higher than those in the control group (P < 0.05). The complication rate of renal damage in the study group was 38.21% (47/123), and the positive rates of serum ZnT8A, GADA and IA-2A in the complicated group were 74.47%, 85.11% and 78.72%, respectively, which were higher than those in non-complicated group (P < 0.05). Multivariate Logistic regression analysis showed that the course of type 1 diabetes, cystatin C (CysC), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), urinary N-acetyl-β-d-glucosaminidase (NAG), diastolic blood pressure, serum uric acid, hemoglobin (Hb) and serum ZnT8A, GADA and IA-2A were all risk factors for renal damage in children with type 1 diabetes (P < 0.05).

  Conclusion  The positive rates of serum ZnT8A, GADA and IA-2A in children with type 1 diabetes mellitus are significantly higher than those in normal children, and positive rates of children with renal damage complicating renal injury are higher than those in children without renal damage. The positive results of serum levels of ZnT8A, GADA and IA-2A, longer course of diabetes, higher CysC, higher FBG, higher HbA1c, higher NAG, higher serum uric acid, higher diastolic blood pressure and lower Hb can also increase the risk of renal damage in children with type 1 diabetes, so prevention and control should be strengthened accordingly.