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- Title
Stratification of type 1 diabetes risk on the basis of islet autoantibody characteristics.
- Authors
Achenbach, Peter; Warncke, Katharina; Reiter, Jürgen; Naserke, Heike E.; Williams, Alistair J. K.; Bingley, Polly J.; Bonifacio, Ezio; Ziegler, Anette-G.; Reiter, Jürgen
- Abstract
Family history of type 1 diabetes and autoantibodies to the islet antigens insulin (IAA), glutamate decarboxylase (GADA), and the protein tyrosine phosphatase-like protein IA-2 (IA-2A) are strong predictors of type 1 diabetes, but the rate of progression to diabetes in multiple islet autoantibody-positive relatives varies widely. We asked whether detailed characterization of islet autoantibodies that included determination of titer, epitope specificity, and IgG subclass would improve diabetes prediction in a large cohort of autoantibodypositive relatives. The study shows a strong association between risk and high titer, broad antibody responses to IA-2 and insulin. The highest risks were associated with high-titer IA-2A and IAA, IgG2, IgG3, and/or IgG4 subclass of IA-2A and IAA, and antibodies to the IA-2related molecule IA-2β. Using models based on these antibody characteristics, autoantibody-positive relatives can be classified into groups with risks of diabetes ranging from 7 to 89% within 5 years.
- Subjects
DIABETES risk factors; ISLANDS of Langerhans; AUTOANTIBODIES; ANTIGENS; INSULIN; RISK management in business; COMPARATIVE studies; ENZYMES; FAMILIES; IMMUNOGLOBULINS; TYPE 1 diabetes; RESEARCH methodology; MEDICAL cooperation; MULTIVARIATE analysis; RESEARCH; RISK assessment; EVALUATION research
- Publication
Diabetes, 2004, Vol 53, Issue 2, p384
- ISSN
0012-1797
- Publication type
journal article
- DOI
10.2337/diabetes.53.2.384