Pancreatic islet autoantibodies as predictors of type 1 diabetes in the Diabetes Prevention Trial-Type 1.
Pancreatic islet autoantibodies as predictors of type 1 diabetes in the Diabetes Prevention Trial-Type 1.
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DOI：
10.2337/dc09-0934
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发表时间：
2009-12
期刊：
影响因子：
16.2
通讯作者：
Diabetes Prevention Trial-Type 1 Study Group
中科院分区：
文献类型：
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作者：
Orban T;Sosenko JM;Cuthbertson D;Krischer JP;Skyler JS;Jackson R;Yu L;Palmer JP;Schatz D;Eisenbarth G;Diabetes Prevention Trial-Type 1 Study Group
通过单独或联合检测特定类型的胰岛自身抗体来预测1型糖尿病的大型前瞻性研究提供的信息有限。因此，我们研究了特异性自身抗体预测1型糖尿病的程度。两个队列来自1型糖尿病预防试验(DPT-1)的胰岛细胞自身抗体(ICA)的首次筛查。同时检测GAD65(GAD65)、胰岛素瘤相关抗原-2(ICA512)和胰岛素(MIAA)自身抗体。受试者被跟踪观察1型糖尿病的发生情况。一个队列(问卷)包括那些没有进入DPT-1试验，但对问卷有回答的人(n=28,507，2.4%ICA+)。其他队列(试验)包括DPT-1参与者(n=528，83.3%ICA+)。在这两个队列中，自身抗体数量对1型糖尿病有很高的预测性(P<；0.001)。根据自身抗体的类型，使用问卷队列来评估预测。作为单一自身抗体，ICA(3.9%)、GAD65(4.4%)和ICA512(4.6%)在比例风险模型中预测1型糖尿病的作用相似(P<；0.001)。然而，没有MIAA作为单一自身抗体的受试者患上1型糖尿病。作为第二自身抗体，除MIAA外，所有抗体均显著增加了1型糖尿病的预测作用(P<；0.001)。在阳性范围内，GAD65和ICA自身抗体滴度可预测1型糖尿病。数据表明，自身抗体的数量是1型糖尿病的预测指标。然而，与其他自身抗体相比，MIAA对1型糖尿病的预测能力较差。在计划1型糖尿病的预防试验时，必须仔细考虑自身抗体的数量、自身抗体的类型和自身抗体效价。
There is limited information from large-scale prospective studies regarding the prediction of type 1 diabetes by specific types of pancreatic islet autoantibodies, either alone or in combination. Thus, we studied the extent to which specific autoantibodies are predictive of type 1 diabetes. Two cohorts were derived from the first screening for islet cell autoantibodies (ICAs) in the Diabetes Prevention Trial–Type 1 (DPT-1). Autoantibodies to GAD 65 (GAD65), insulinoma-associated antigen-2 (ICA512), and insulin (micro-IAA [mIAA]) were also measured. Participants were followed for the occurrence of type 1 diabetes. One cohort (Questionnaire) included those who did not enter the DPT-1 trials, but responded to questionnaires (n = 28,507, 2.4% ICA+). The other cohort (Trials) included DPT-1 participants (n = 528, 83.3% ICA+). In both cohorts autoantibody number was highly predictive of type 1 diabetes (P < 0.001). The Questionnaire cohort was used to assess prediction according to the type of autoantibody. As single autoantibodies, ICA (3.9%), GAD65 (4.4%), and ICA512 (4.6%) were similarly predictive of type 1 diabetes in proportional hazards models (P < 0.001 for all). However, no subjects with mIAA as single autoantibodies developed type 1 diabetes. As second autoantibodies, all except mIAA added significantly (P < 0.001) to the prediction of type 1 diabetes. Within the positive range, GAD65 and ICA autoantibody titers were predictive of type 1 diabetes. The data indicate that the number of autoantibodies is predictive of type 1 diabetes. However, mIAA is less predictive of type 1 diabetes than other autoantibodies. Autoantibody number, type of autoantibody, and autoantibody titer must be carefully considered in planning prevention trials for type 1 diabetes.