Prediction of type 1 diabetes in the general population.
Prediction of type 1 diabetes in the general population.
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DOI：
10.2337/dc09-1040
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发表时间：
2010-06
期刊：
影响因子：
16.2
通讯作者：
Akerblom HK
中科院分区：
文献类型：
--
作者：
Knip M;Korhonen S;Kulmala P;Veijola R;Reunanen A;Raitakari OT;Viikari J;Akerblom HK
评估GAD抗体（GADA）和胰岛抗原-2抗体（IA-2As）在预测一般人群27年以上1型糖尿病中的效用，并评估6年血清转换率。1980年共对3,475名3-18岁的非糖尿病受试者进行了抽样，1986年对2,375名受试者（68.3%）进行了重新抽样。观察所有受试者的糖尿病发展至2007年底。在1980年和1986年获得的所有样品中分析了GADA和IA-2As。共有34名患者（1.0%; 9名发展为糖尿病）最初患有GADA，22名患者（0.6%; 9名发展为糖尿病）患有IA-2A。7例受试者（0.2%）的两种自身抗体检测结果均为阳性。GADA和IA-2As的6年阳性血清转换率分别为0.4%和0.2%，而反向血清转换率分别为33%和57%。18例受试者（0.5%）在中位糖尿病前期8.6年（范围0.9-20.3）后发生1型糖尿病。GADA和/或IA-2As的初始阳性对1型糖尿病的敏感性为61%（95% CI 36-83）。GADA和IA-2A联合阳性的特异性和阳性预测值均为100%（95% CI 59-100）。在芬兰的一般儿童人群中进行GADA和IA-2A的一次性筛查，将确定在未来27年内将发展为1型糖尿病的人中有60%，并且具有两种自身抗体的受试者具有极高的糖尿病风险。随着时间的推移，阳性和反向血清转化都发生，反映了β细胞自身免疫的动态过程。
To evaluate the utility of GAD antibodies (GADAs) and islet antigen-2 antibodies (IA-2As) in prediction of type 1 diabetes over 27 years in the general population and to assess the 6-year rates of seroconversion. A total of 3,475 nondiabetic subjects aged 3–18 years were sampled in 1980, and 2,375 subjects (68.3%) were resampled in 1986. All subjects were observed for development of diabetes to the end of 2007. GADAs and IA-2As were analyzed in all samples obtained in 1980 and 1986. A total of 34 individuals (1.0%; 9 developed diabetes) initially had GADAs and 22 (0.6%; 9 developed diabetes) IA-2As. Seven subjects (0.2%) tested positive for both autoantibodies. The positive seroconversion rate over 6 years was 0.4% for GADAs and 0.2% for IA-2As, while the inverse seroconversion rates were 33 and 57%, respectively. Eighteen subjects (0.5%) developed type 1 diabetes after a median pre-diabetic period of 8.6 years (range 0.9–20.3). Initial positivity for GADAs and/or IA-2As had a sensitivity of 61% (95% CI 36–83) for type 1 diabetes. Combined positivity for GADAs and IA-2As had both a specificity and a positive predictive value of 100% (95% CI 59–100). One-time screening for GADAs and IA-2As in the general childhood population in Finland would identify ∼60% of those individuals who will develop type 1 diabetes over the next 27 years, and those subjects who have both autoantibodies carry an extremely high risk for diabetes. Both positive and inverse seroconversions do occur over time reflecting a dynamic process of β-cell autoimmunity.
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影响因子：
8.2
作者：
Siljander, H. T.;Veijola, R.;Knip, M.
通讯作者：
Knip, M.
影响因子：
5.8
作者：
Kimpim채ki, T;Kupila, A;Knip, M
通讯作者：
Knip, M
影响因子：
16.2
作者：
LaGasse, JM;Palmer, JP;Monks, S
通讯作者：
Monks, S
影响因子：
8.2
作者：
BONIFACIO, E;GENOVESE, S;BOSI, E
通讯作者：
BOSI, E
影响因子：
8.2
作者：
Kulmala, P;Rahko, J;Knip, M
通讯作者：
Knip, M