Adenosine deaminase isoenzyme activity in blood plasma of young patients with type 1 diabetes: a correlative analysis

Abstract

The global incidence of T1D is increasing, particularly among children, adolescents, and young adults. Adenosine deaminase (ADA) isoenzymes, specifically ADA1 and ADA2, are key regulators of the immune system and are potential biomarkers for autoimmune conditions such as T1D. This study investigated ADA isoenzyme activity in the plasma of young Armenian T1D patients to determine whether these enzymes could serve as biomarkers of immune status and disease progression. We analyzed ADA isoenzyme activity in young Armenian T1D patients and compared it to that of healthy controls. We also established normal ADA2 reference values for healthy children, noting age- and sex-dependent variations. Healthy children showed age- and sex-dependent variations in ADA2 activity, with levels correlating positively with age in adults but showing no significant change up to 20 years of age. T1D patients had significantly higher total ADA, ADA1, and especially ADA2 levels than the controls. ROC analysis confirmed ADA2’s strong diagnostic potential for T1D (AUC up to 0.822). Notably, ADA isoenzyme activities did not correlate with long-term glycemic control (HbA1c). In patients with T1D, ADA isoenzyme levels, particularly ADA2, are significantly elevated compared with healthy controls, suggesting heightened immune and inflammatory responses. The statistically significant AUC values across all comparisons underscore ADA2’s potential as a valuable diagnostic or monitoring biomarker, independent of blood sugar levels, particularly in the young population.