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- Document type:
- Journal Article
- Author(s):
- Achenbach, P; Warncke, K; Reiter, J; Williams, AJ; Ziegler, AG; Bingley, PJ; Bonifacio, E
- Title:
- Type 1 diabetes risk assessment: improvement by follow-up measurements in young islet autoantibody-positive relatives.
- Abstract:
- 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.
- Journal title abbreviation:
- Diabetologia
- Year:
- 2006
- Journal volume:
- 49
- Journal issue:
- 12
- Pages contribution:
- 2969-76
- Language:
- eng
- Fulltext / DOI:
- doi:10.1007/s00125-006-0451-9
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/17019596
- Print-ISSN:
- 0012-186X
- TUM Institution:
- Klinik und Poliklinik für Kinderheilkunde und Jugendmedizin
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