Development of autoantibodies to islet antigens during childhood: implications for preclinical type 1 diabetes screening
- 1 September 2002
- journal article
- Published by Hindawi Limited in Pediatric Diabetes
- Vol. 3 (3), 144-148
- https://doi.org/10.1034/j.1399-5448.2002.30304.x
Abstract
Serum islet antibodies signify increased risk for type 1 diabetes (T1D). Knowledge of the relationship between age and seroconversion would guide screening for at-risk individuals. We aimed to determine the effectiveness of islet antibody screening in early childhood, in particular the proportion of negative children who subsequently seroconverted. We identified 554 children with a first-degree relative with T1D who had tested negative for islet cell antibodies (ICA) and insulin autoantibodies (IAA) when first screened at a mean age of 7.2 yr. Of 423 who were eligible, 350 consented to re-testing for ICA and IAA and antibodies to glutamic acid decarboxylase (GADAb) and tyrosine phosphatase-like insulinoma antigen IA-2 (IA2Ab) at a mean age of 11.1 yr. GADAb and IA2Ab were measured in 239 of the initial stored samples. Of the 350 children who tested negative at first screening, 12 (3.4%) subsequently seroconverted, becoming positive for ICA (n = 4), IAA (n = 7), GADAb (n = 6) or IA2Ab (n = 2). Of 239 initially negative for ICA and IAA, 8/239 (3.3%) now tested positive for GADAb (n = 7) or IA2Ab (n = 1). Four of these children were positive for GADAb in both tests; the one child initially positive for IA2Ab only was positive for all four antibodies 4.6 yr later and developed diabetes. Screening for ICA and IAA failed to identify 2-3% of genetically at-risk children who subsequently developed islet antibodies. Testing for GADAb and IA2Ab would not have avoided this. Maximizing the sensitivity of detecting risk for T1D requires repeat screening for islet antibodies throughout childhood.Keywords
This publication has 7 references indexed in Scilit:
- The Melbourne Pre‐Diabetes Study: prediction of type 1 diabetes mellitus using antibody and metabolic testingThe Medical Journal of Australia, 1998
- Value of ICA512 antibodies for prediction and diagnosis of type 1 diabetesExperimental and Clinical Endocrinology & Diabetes, 1996
- Islet autoantibody markers in IDDM: risk assessment strategies yielding high sensitivityDiabetologia, 1995
- Anti-glutamate decarboxylase and other antibodies at the onset of childhood IDDM: a population-based studyDiabetologia, 1994
- A Prospective Study of the Development of Diabetes in Relatives of Patients with Insulin-Dependent DiabetesNew England Journal of Medicine, 1990
- A sensitive and reproducible method for the assay of human islet cell antibodiesJournal of Immunological Methods, 1990
- Competitive Insulin Autoantibody Assay: Prospective Evaluation of Subjects at High Risk for Development of Type I Diabetes MellitusDiabetes, 1987