Document Detail


Type 1 diabetes risk assessment: improvement by follow-up measurements in young islet autoantibody-positive relatives.
MedLine Citation:
PMID:  17019596     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS/HYPOTHESIS: Combinations of autoantibody characteristics, including antibody number, titre, subclass and epitope have been shown to stratify type 1 diabetes risk in islet autoantibody-positive relatives. The aim of this study was to determine whether autoantibody characteristics change over time, the nature of such changes, and their implications for the development of diabetes. METHODS: Five-hundred and thirteen follow-up samples from 141 islet autoantibody-positive first-degree relatives were tested for islet autoantibody titre, IgG subclass, and GAD and IA-2 antibody epitope. All samples were categorised according to four risk stratification models. Relatives had a median follow-up of 6.8 years and 48 developed diabetes during follow-up. Survival analysis was used to determine the probability of change in risk category and of progression to diabetes. RESULTS: For each stratification model, the majority of relatives (71-81%) remained in the same risk category throughout follow-up. In the remainder, changes occurred both from lower to higher and from higher to lower risk categories. For all four models, relatives aged < 15 years were more likely to change risk category than those aged >15 years (0.001 < p < 0.03). Relatives whose autoantibody status changed from low- to high-risk categories had a higher risk of diabetes than relatives who remained in low-risk categories, and inclusion of autoantibody status during follow-up improved diabetes risk stratification in Cox proportional hazards models (p < 0.001). CONCLUSIONS/INTERPRETATION: Changes in islet autoantibodies are relevant to pathogenesis, and are likely to signal alterations in the disease process. Detection of changes through follow-up measurement will improve diabetes risk stratification, particularly in young individuals.
Authors:
P Achenbach; K Warncke; J Reiter; A J K Williams; A G Ziegler; P J Bingley; E Bonifacio
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-09-26
Journal Detail:
Title:  Diabetologia     Volume:  49     ISSN:  0012-186X     ISO Abbreviation:  Diabetologia     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-10     Completed Date:  2007-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2969-76     Citation Subset:  IM    
Affiliation:
Diabetes Research Institute, Koelner Platz 1, Munich, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Autoantibodies / blood*
Child
Child, Preschool
Diabetes Mellitus, Type 1 / epidemiology*,  genetics*,  mortality
Family
Follow-Up Studies
Humans
Islets of Langerhans / immunology*
Middle Aged
Models, Genetic
Proportional Hazards Models
Risk Assessment
Survival Analysis
Time Factors
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/islet cell antibody

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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