A Possible Diagnostic Value of Zinc Transporter-8 Autoantibody for Pediatrics Type 1 Diabetic Ketoacidosis; A Systematic Review

Background: Type 1 diabetes mellitus (T1D) is a health concern all around the world. One of the most dramatic features of this disease is pediatric incidence. The most important metabolic clinical feature of T1D is ketosis and ketoacidosis. The exact role of autoantibodies in T1D pathogenesis is not completely clear yet. However, the diagnostic use for these autoantibodies is established. Zinc Transporter-8 Autoantibody (ZnT8A) is assumed to be the most specific antibody for islet beta cells. The current study aims to evaluate all relevant documents with possible risk and diagnostic value of ZnT8A for pediatrics T1D ketoacidosis (DKA) by a systematic review approach. Materials and methods: Most popular electronic databases such as PubMed, Scopus, Science Direct, and Google Scholar were used for searches the following keywords pediatrics, children, diabetic ketoacidosis, type 1 diabetes mellitus, zinc transporter-8 autoantibodies without year or any other limitations. All relevant original studies that mention ZnT8A and Ketosis or DKA in the pediatric population were evaluated and in case of being matched with the criteria extracted. Results: Primary search results led to 7233 queries. By considering the study inclusion criteria and bias assessment, six studies were included. Majority of included studies suggested ZnT8A as a risk factor for DKA in T1D pediatrics. Conclusion: The current study tried to provide an overview on the conducted studies in possible risk and diagnostic value of ZnT8A for pediatrics DKA. The majority of included studies suggest the ZnT8A as a risk factor with diagnostic association to DKA, while there are some conflicting documents. We tried to highlight the importance of this research theme for future studies to maintain a more precise conclusion with clinical relevance.