Prediction of type 1 diabetes among siblings of affected children and in the general population
Prediction of type 1 diabetes among siblings of affected children and in the general population
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DOI：
10.1007/s00125-007-0799-5
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发表时间：
2007-11-01
期刊：
影响因子：
8.2
通讯作者：
Knip, M.
中科院分区：
文献类型：
--
作者：
Siljander, H. T.;Veijola, R.;Knip, M.
目的/假设比较GADA和IA-2A自身抗体对1型糖尿病患病儿童同胞和普通人群儿童的预测特征。方法对755名同胞和3,475名人群来源的儿童进行GADA和IA-2A筛查，并对1型糖尿病观察15年。结果五十六例（7.4%）同胞GADA阳性，39例（5.2%）IA-2A阳性，29例（3.8%）两种自身抗体阳性。34例人群来源的参与者（1.0%）有GADA，22例（0.6%）有IA-2A，7例（0.2%）有双重阳性。在人群队列中，51名兄弟姐妹（6.8%）和15名参与者（0.4%）进展为1型糖尿病。GADA的预测灵敏度在同胞中为68%（95% CI 53-81%），在一般人群中为50%（95% CI 23-77%），而IA-2A的相应值为58（95% CI 43-72%）和43%（95% CI 18-71%）。双自身抗体阳性在同胞中的敏感性为48%（95%CI 34-63%），在人群队列中为36%（95%CI 13-65%）。GADA、IA-2A和双阳性的累积疾病风险分别为61%（95% CI 48-74%），74%（95% CI 61-88%）和83%（95% CI 69-97%），相比之下，（95% CI 9-38%），百分之三十二（95% CI 12-51%）和86%（95%CI 60-100%）。结论/解释GADA和IA的疾病预测敏感性无显著差异。2A阳性或其组合之间的兄弟姐妹和人口队列，而对于每种抗体，阳性与较高的累积疾病风险之间的兄弟姐妹。双抗体阳性在兄弟姐妹和一般人群中具有相似的累积疾病风险。
Aims/hypothesis To compare the predictive characteristics of autoantibodies to GAD (GADA) and islet antigen 2 (IA-2A) for type 1 diabetes between siblings of affected children and children from the general population.Methods Seven-hundred and fifty-five siblings and 3,475 population-derived children were screened for GADA and IA-2A and observed for type 1 diabetes for 15 years. Sensitivity and cumulative disease risks from GADA, IA-2A and double positivity were compared between the cohorts.Results Fifty-six siblings (7.4%) tested positive for GADA, 39 (5.2%) for IA-2A and 29 (3.8%) for both autoantibodies. Thirty-four population derived participants (1.0%) had GADA, 22 (0.6%) had IA-2A and 7 (0.2%) had double positivity. Fifty-one siblings (6.8%) and 15 participants in the population cohort (0.4%) progressed to type 1 diabetes. The predictive sensitivity of GADA was 68% (95% CI 53-81%) among siblings and 50% (95% CI 23-77%) in the general population, while the corresponding values were 58 (95% CI 43-72%) and 43% (95% CI 18-71%) for IA-2A. Double-autoantibody positivity had a sensitivity of 48% (95% CI 34-63%) among siblings and 36% (95% CI 13-65%) in the population cohort. Cumulative disease risks from GADA, IA-2A and double positivity were, respectively, 61% (95% CI 48-74%), 74% (95% CI 61-88%) and 83% (95% CI 69-97%) among siblings compared with those of 24% (95% CI 9-38%), 32% (95% CI 12-51%) and 86% (95% CI 60-100%) in the general population.Conclusions/interpretation There were no significant differences in the disease-predictive sensitivity of GADA and IA-2A positivity or their combination between siblings and the population cohort, whereas, for each antibody, positivity was associated with a higher cumulative disease risk among siblings. Double-antibody positivity conferred similar cumulative disease risk both among siblings and in the general population.