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- Title
The Prediction of Type 1 Diabetes by Multiple Autoantibody Levels and Their Incorporation Into an Autoantibody Risk Score in Relatives of Type 1 Diabetic Patients.
- Authors
SOSENKO, JAY M.; SKYLER, JAY S.; PALMER, JERRY P.; KRISCHER, JEFFREY P.; LIPING YU; MAHON, JEFFREY; BEAM, CRAIG A.; BOULWARE, DAVID C.; RAFKIN, LISA; SCHATZ, DESMOND; EISENBARTH, GEORGE
- Abstract
OBJECTIVE--We assessed whether a risk score that incorporates levels of multiple islet autoantibodies could enhance the prediction of type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS--TrialNet Natural History Study participants (n = 784) were tested for three autoantibodies (GADA, IA-2A, and mIAA) at their initial screening. Samples from those positive for at least one autoantibody were subsequently tested for ICA and ZnT8A. An autoantibody risk score (ABRS) was developed from a proportional hazards model that combined autoantibody levels from each autoantibody along with their designations of positivity and negativity. RESULTS--The ABRS was strongly predictive of T1D (hazard ratio [with 95% CI] 2.72 [2.23-3.31], P < 0.001). Receiver operating characteristic curve areas (with 95% CI) for the ABRS revealed good predictability (0.84 [0.78-0.90] at2years, 0.81 [0.74-0.89] at3years,P, 0.001 for both). The composite of levels from the five autoantibodies was predictive of T1D before and after an adjustment for the positivity or negativity of autoantibodies (P < 0.001). The findings were almost identical when ICA was excluded from the risk score model. The combination of the ABRS and the previously validated Diabetes Prevention Trial--Type 1 Risk Score (DPTRS) predicted T1D more accurately (0.93 [0.88-0.98] at 2 years, 0.91 [0.83-0.99] at 3 years) than either the DPTRS or the ABRS alone (P ≤ 0.01 for all comparisons). CONCLUSIONS--These findings show the importance of considering autoantibody levels in assessing the risk of T1D. Moreover, levels of multiple autoantibodies can be incorporated into an ABRS that accurately predicts T1D.
- Subjects
AUTOANTIBODIES; TYPE 1 diabetes; DISEASE susceptibility; DIAGNOSIS of diabetes; DIABETES; DIAGNOSIS
- Publication
Diabetes Care, 2013, Vol 36, Issue 9, p2615
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc13-0425