We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Development of Autoantibodies in the TrialNet Natural History Study.
- Authors
VEHIK, KENDRA; BEAM, CRAIG A.; MAHON, JEFFREY L.; SCHATZ, DESMOND A.; HALLER, MICHAEL J.; SOSENKO, JAY M.; SKYLER, JAY S.; KRISCHER, JEFFREY P.
- Abstract
OBJECTIVE--Understanding the relationship between age and islet autoantibody (Ab) seroconversion can establish the optimal screening interval(s) to assess risk for type 1 diabetes, identify subjects who can participate in prevention trials, and determine associated costs. This study assessed the rates of seroconversion to glutamic acid decarboxylase positive (GAD65+), insulin positive (mIAa+), and insulinoma-associated protein 2 positive (ICA512+) in a large cohort of relatives of type 1 diabetes probands undergoing Ab rescreening ill the TrialNet Natural History Study. RESEARCH DESIGN AND METHODS--Of 32,845 children aged < 18 years screened for Abs, 1,287 (3.9%) were GAD65+, 778 (2.4%) were mIAA+, 677 (2.1%) were 1CA512+, and 31,038 were Ab-negative. Ab-negative children were offered annual rescreening up to 18 years of age. Cox regression was used to estimate the risk for GAD65, mIAA, and ICA512 seroconversion. RESULTS--There were 205 children who seroconverted to GAD65+, 155 who seroconverted to mIAA+, and 53 who seroconverted to ICA512+ over 5.8 years of follow-up The risk of mIAA (hazard ratio 0.89 [95% CI 0.85-0.92]) and GAD65 (0.96 [0.93-0.991) seroconversion significantly decreased with increasing age (i.e., for each 1-year increase in age, the risk of seroconversion decreased by 11% [P < 0.0001] for mIAA and 4% [P = 0.04] for GAD65) across all ages. The cumulative Ab seroconversion was 2% for those < 10 years of age versus 0.7% for those ≥ 10 years of age. CONCLUSIONS--The risk of development of islet Abs declines with increasing age in type 1 diabetes relatives. These data support annual screening for children < 10 years of age and one additional screening in adolescence.
- Subjects
AGE; AUTOANTIBODIES; IMMUNOGLOBULINS; SEROCONVERSION; NATURAL history; DIABETES
- Publication
Diabetes Care, 2011, Vol 34, Issue 9, p1897
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc11-0560