Islet autoantibodies, nationality and gender: a multinational screening study in first-degree relatives of patients with Type I diabetes
Islet autoantibodies, nationality and gender: a multinational screening study in first-degree relatives of patients with Type I diabetes
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DOI：
10.1007/s00125-001-0749-6
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发表时间：
2002-02-01
期刊：
影响因子：
8.2
通讯作者：
Gale, EAM
中科院分区：
文献类型：
--
作者：
Williams, AJK;Bingley, PJ;Gale, EAM
目的/假设。在一项国际糖尿病预防试验的招募过程中，对20岁或以下诊断为I型（胰岛素依赖型）糖尿病患者的一级亲属进行胰岛细胞抗体（伊卡）筛查。我们的目的是评估年龄、性别、先证者特征和民族对伊卡患病率以及GAD、IA-2和胰岛素自身抗体共存的影响。中心实验室筛选了来自8个欧洲国家的10326名年龄小于40岁的非糖尿病亲属的ICA样本。在伊卡≥ 10 JDF单位的所有样本中检测GAD和IA-2抗体。总体而言，8.9%的亲属伊卡为10个JDF单位或以上，3.8%的亲属伊卡为20个JDF单位或以上。在伊卡为10个JDF单位或更高的921名亲属中，29%的人同时存在GAD或IA-2抗体或两者兼而有之。ICA ≥ 10个JDF单位的男性（10.8%）比女性（7.3%）更常见。伊卡伴GAD或IA-2抗体或两者同时存在在男性（3.4%）中也比女性（1.9%）和20岁以下亲属（3.5% vs 1.5%）更常见。多元回归分析显示，国籍是伊卡的10个JDF单位或更多，但不是伊卡的20个JDF单位或更多或伊卡与共存的胰岛抗体的决定因素，并确认了年龄和性别作为胰岛自身免疫的决定因素的重要性。尽管儿童糖尿病的背景发病率差异很大，但来自不同欧洲国家的亲属具有相似的胰岛自身免疫率，并且男性过量在所有人群中同样明显。10岁以上男性伊卡和胰岛自身免疫的过度反映了该年龄组I型糖尿病的男性发病率较高，并表明男孩可能比女孩更有可能在青春期发展胰岛自身免疫。
Aims/hypothesis. First-degree relatives of patients with Type I (insulin-dependent) diabetes mellitus diagnosed at 20 years of age or under were screened for islet cell antibodies (ICA) in the course of recruitment to an international diabetes prevention trial. Our aim was to evaluate the influence of age, gender, proband characteristics and nationality on the prevalence of ICA and co-existence of autoantibodies to GAD, IA-2 and insulin.Methods. A central laboratory screened samples from 10326 non-diabetic relatives who were aged less than 40 years, from eight European countries for ICA. Antibodies to GAD and IA-2 were measured in all samples with ICA of 10 JDF units or more.Results. Overall, 8.9 % of relatives had ICA of 10 JDF units or more, 3.8 % with ICA of 20 JDF units or more. Of 921 relatives with ICA of 10 JDF units or more, 29 % had co-existing antibodies to GAD or IA-2 or both. ICA of 10 JDF units or more were more prevalent in males (10.8 %) than females (7.3 %). ICA with GAD or IA-2 antibodies or both were also more common in males (3.4 %) than females (1.9 %) and in relatives under 20 years of age (3.5 % vs 1.5 %). Multiple regression analysis showed nationality to be a determinant of ICA of 10 JDF units or more but not of ICA of 20 JDF units or more or of ICA with co-existing islet antibodies, and confirmed the importance of age and gender as determinants of islet autoimmunity.Conclusions/interpretation. Relatives from different European countries have similar rates of islet autoimmunity despite wide variation in the background incidence of childhood diabetes, and male excess is equally evident in all populations. The male excess of ICA and islet autoimmunity over 10 years of age reflects the higher male incidence of Type I diabetes in this age group, and suggests that boys may be more likely than girls to develop islet autoimmunity during adolescence.