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The 6 year incidence of diabetes-associated autoantibodies in genetically at-risk children: the TEDDY study.
Diabetologia. 2015 May; 58(5):980-7.D

Abstract

AIMS/HYPOTHESIS

Islet autoantibodies, in addition to elevated blood glucose, define type 1 diabetes. These autoantibodies are detectable for a variable period of time before diabetes onset. Thus, the occurrence of islet autoantibodies is associated with the beginning of the disease process. The age at, and order in, which autoantibodies appear may be associated with different genetic backgrounds or environmental exposures, or both.

METHODS

Infants with HLA-DR high-risk genotypes (DR3/4, DR4/4, DR4/8 and DR3/3) were enrolled and prospectively followed with standardised autoantibody assessments quarterly throughout the first 4 years of life and then semi-annually thereafter.

RESULTS

Autoantibodies appeared in 549/8,503 (6.5%) children during 34,091 person-years of follow-up. Autoantibodies at 3 (0.1%) and 6 (0.2%) months of age were rare. Of the 549, 43.7% had islet autoantibodies to insulin (IAA) only, 37.7% had glutamic acid decarboxylase autoantibodies (GADA) only, 13.8% had both GADA and IAA only, 1.6% had insulinoma antigen-2 only and 3.1% had other combinations. The incidence of IAA only peaked within the first year of life and declined over the following 5 years, but GADA only increased until the second year and remained relatively constant. GADA only were more common than IAA only in HLA-DR3/3 children but less common in HLA-DR4/8 children.

CONCLUSIONS/INTERPRETATION

Islet autoantibodies can occur very early in life and the order of appearance was related to HLA-DR-DQ genotype.

Authors+Show Affiliations

Department of Pediatrics, Morsani College of Medicine, University of South Florida, 3650 Spectrum Boulevard, Suite 100, Tampa, FL, 33612, USA, jeffrey.krischer@epi.usf.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25660258

Citation

Krischer, Jeffrey P., et al. "The 6 Year Incidence of Diabetes-associated Autoantibodies in Genetically At-risk Children: the TEDDY Study." Diabetologia, vol. 58, no. 5, 2015, pp. 980-7.
Krischer JP, Lynch KF, Schatz DA, et al. The 6 year incidence of diabetes-associated autoantibodies in genetically at-risk children: the TEDDY study. Diabetologia. 2015;58(5):980-7.
Krischer, J. P., Lynch, K. F., Schatz, D. A., Ilonen, J., Lernmark, Å., Hagopian, W. A., Rewers, M. J., She, J. X., Simell, O. G., Toppari, J., Ziegler, A. G., Akolkar, B., & Bonifacio, E. (2015). The 6 year incidence of diabetes-associated autoantibodies in genetically at-risk children: the TEDDY study. Diabetologia, 58(5), 980-7. https://doi.org/10.1007/s00125-015-3514-y
Krischer JP, et al. The 6 Year Incidence of Diabetes-associated Autoantibodies in Genetically At-risk Children: the TEDDY Study. Diabetologia. 2015;58(5):980-7. PubMed PMID: 25660258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The 6 year incidence of diabetes-associated autoantibodies in genetically at-risk children: the TEDDY study. AU - Krischer,Jeffrey P, AU - Lynch,Kristian F, AU - Schatz,Desmond A, AU - Ilonen,Jorma, AU - Lernmark,Åke, AU - Hagopian,William A, AU - Rewers,Marian J, AU - She,Jin-Xiong, AU - Simell,Olli G, AU - Toppari,Jorma, AU - Ziegler,Anette-G, AU - Akolkar,Beena, AU - Bonifacio,Ezio, AU - ,, Y1 - 2015/02/10/ PY - 2014/09/04/received PY - 2015/01/13/accepted PY - 2015/2/10/entrez PY - 2015/2/11/pubmed PY - 2016/1/21/medline SP - 980 EP - 7 JF - Diabetologia JO - Diabetologia VL - 58 IS - 5 N2 - AIMS/HYPOTHESIS: Islet autoantibodies, in addition to elevated blood glucose, define type 1 diabetes. These autoantibodies are detectable for a variable period of time before diabetes onset. Thus, the occurrence of islet autoantibodies is associated with the beginning of the disease process. The age at, and order in, which autoantibodies appear may be associated with different genetic backgrounds or environmental exposures, or both. METHODS: Infants with HLA-DR high-risk genotypes (DR3/4, DR4/4, DR4/8 and DR3/3) were enrolled and prospectively followed with standardised autoantibody assessments quarterly throughout the first 4 years of life and then semi-annually thereafter. RESULTS: Autoantibodies appeared in 549/8,503 (6.5%) children during 34,091 person-years of follow-up. Autoantibodies at 3 (0.1%) and 6 (0.2%) months of age were rare. Of the 549, 43.7% had islet autoantibodies to insulin (IAA) only, 37.7% had glutamic acid decarboxylase autoantibodies (GADA) only, 13.8% had both GADA and IAA only, 1.6% had insulinoma antigen-2 only and 3.1% had other combinations. The incidence of IAA only peaked within the first year of life and declined over the following 5 years, but GADA only increased until the second year and remained relatively constant. GADA only were more common than IAA only in HLA-DR3/3 children but less common in HLA-DR4/8 children. CONCLUSIONS/INTERPRETATION: Islet autoantibodies can occur very early in life and the order of appearance was related to HLA-DR-DQ genotype. SN - 1432-0428 UR - https://www.unboundmedicine.com/medline/citation/25660258/The_6_year_incidence_of_diabetes_associated_autoantibodies_in_genetically_at_risk_children:_the_TEDDY_study_ L2 - https://doi.org/10.1007/s00125-015-3514-y DB - PRIME DP - Unbound Medicine ER -