The Karlsburg Type I (insulin-dependent) diabetes risk study on schoolchildren aims to evaluate the predictive diagnostic value of diabetes-associated autoantibodies in the general population.
We took capillary serum from 9419 schoolchildren, aged 6-17 years, for testing of autoantibodies (AAbs) to glutamic acid decarboxylase (GADA), protein tyrosine phosphatase (IA2A) and insulin (IAA) by 125I-antigen binding.
We also tested for autoantibodies to cytoplasmic islet cell antigens (ICA) immunohistochemically.
By testing of 9419 sera for the four AAbs at cut-off at or greater than the 98th centile for the radioassayed AAbs and at or greater than 10 Juvenile Diabetes Foundation (JDF) units for ICA, 8.1% of schoolchildren had at least one AAb.
We found that 3.04,2.97,2.35, and 0.86% had IAA, GADA, IA2A or ICA, respectively. 7.3% had only one AAb and 0.8% (75) had two or more AAbs, reflecting a risk to develop diabetes.
Thus, by primary screening by combined testing of GADA and IA2A, 98.7% (74/75) would be identified.
At high AAb levels, cut-off at or greater than the 99.8th centile and at or greater than 40 JDF units for ICA, 0.23% (22/9419) of schoolchildren, similar to the disease prevalence of 0.3%, had two or more AAbs.
Ten of 17 children tested had reduced (p<0.001) first-phase insulin secretion by intravenous glucose tolerance test.
Six of 22 subjects developed Type I diabetes within a follow-up of 19 ± 10 months. (...)
Mots-clés Pascal : Facteur risque, Age scolaire, Diagnostic, Valeur prédictive, Autoanticorps, Prédiction, Diabète insulinodépendant, Autoimmunité, Endocrinopathie, Immunopathologie, Maladie autoimmune, Enfant, Homme, Epidémiologie
Mots-clés Pascal anglais : Risk factor, School age, Diagnosis, Predictive value, Autoantibody, Prediction, Insulin dependent diabetes, Autoimmunity, Endocrinopathy, Immunopathology, Autoimmune disease, Child, Human, Epidemiology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0327709
Code Inist : 002B21E01A. Création : 16/11/1999.