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Value of antibodies to GAD 65 combined with islet cell cytoplasmic antibodies for predicting IDDM in a childhood population

Value of antibodies to GAD 65 combined with islet cell cytoplasmic antibodies for predicting IDDM... 125 37 37 9 9 H. -J. Aanstoot E. Sigurdsson M. Jaffe Y. Shi S. Christgau D. Grobbee G. J. Bruining J. L. Molenaar A. Hofman S. Baekkeskov Hormone Research Institute, Departments of Microbiology/Immunology and Medicine University of California San Francisco California USA Hagedorn Research Laboratory Gentofte Denmark Department of Epidemiology Erasmus University Medical School Rotterdam The Netherlands Departments of Pediatrics, Division of Congenital/Hereditary Diseases Erasmus University Medical School and Sophia Children's Hospital Rotterdam The Netherlands Department of Immunology Stichting Samenwerkende Delftse Ziekenhuizen Delft The Netherlands Summary The value of a test for islet cell cytoplasmic antibodies together with a test for GAD 65 antibodies to predict the subsequent development of diabetes over a period of 11.5 years was assessed in an open childhood population comprising 2,805 individuals. A single serum sample was obtained from each individual between 1975 and 1977 and screened for islet cell cytoplasmic antibodies for which eight individuals were positive (0.29%). During the average follow-up period of 11.5 years, four of eight islet cell antibody positive and three islet cell antibody negative individuals developed clinical diabetes. Sera from all individuals, who were islet cell antibody positive and/ or developed diabetes (total of 11) and from 100 randomly selected control subjects were analysed for GAD 65 antibodies. Six of eight islet cell antibody positive individuals were GAD 65 antibody positive including all four who subsequently developed IDDM. Furthermore, one of the three islet cell antibody negative individuals who developed IDDM was GAD 65 antibody positive both in 1976 and in 1989. Thus, a positive test for GAD 65 antibodies alone correctly predicted diabetes in five of seven children, who developed the disease. Only one of the children, who developed diabetes was positive for insulin autoantibodies and this individual was also positive for islet cell cytoplasmic antibodies and GAD 65 antibodies. One of the 100 control subjects was positive for GAD 65 antibodies (1%). The results suggest that a single GAD 65 antibody test may have a higher sensitivity for predicting IDDM than a test for islet cell cytoplasmic antibodies, but that a combined positive test for both antibodies increases the specificity for predicting IDDM over a period of 11.5 years. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Diabetologia Springer Journals

Value of antibodies to GAD 65 combined with islet cell cytoplasmic antibodies for predicting IDDM in a childhood population

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References (52)

Publisher
Springer Journals
Copyright
Copyright © 1994 by Springer-Verlag
Subject
Medicine & Public Health; Human Physiology; Internal Medicine; Metabolic Diseases
ISSN
0012-186X
eISSN
1432-0428
DOI
10.1007/BF00400948
Publisher site
See Article on Publisher Site

Abstract

125 37 37 9 9 H. -J. Aanstoot E. Sigurdsson M. Jaffe Y. Shi S. Christgau D. Grobbee G. J. Bruining J. L. Molenaar A. Hofman S. Baekkeskov Hormone Research Institute, Departments of Microbiology/Immunology and Medicine University of California San Francisco California USA Hagedorn Research Laboratory Gentofte Denmark Department of Epidemiology Erasmus University Medical School Rotterdam The Netherlands Departments of Pediatrics, Division of Congenital/Hereditary Diseases Erasmus University Medical School and Sophia Children's Hospital Rotterdam The Netherlands Department of Immunology Stichting Samenwerkende Delftse Ziekenhuizen Delft The Netherlands Summary The value of a test for islet cell cytoplasmic antibodies together with a test for GAD 65 antibodies to predict the subsequent development of diabetes over a period of 11.5 years was assessed in an open childhood population comprising 2,805 individuals. A single serum sample was obtained from each individual between 1975 and 1977 and screened for islet cell cytoplasmic antibodies for which eight individuals were positive (0.29%). During the average follow-up period of 11.5 years, four of eight islet cell antibody positive and three islet cell antibody negative individuals developed clinical diabetes. Sera from all individuals, who were islet cell antibody positive and/ or developed diabetes (total of 11) and from 100 randomly selected control subjects were analysed for GAD 65 antibodies. Six of eight islet cell antibody positive individuals were GAD 65 antibody positive including all four who subsequently developed IDDM. Furthermore, one of the three islet cell antibody negative individuals who developed IDDM was GAD 65 antibody positive both in 1976 and in 1989. Thus, a positive test for GAD 65 antibodies alone correctly predicted diabetes in five of seven children, who developed the disease. Only one of the children, who developed diabetes was positive for insulin autoantibodies and this individual was also positive for islet cell cytoplasmic antibodies and GAD 65 antibodies. One of the 100 control subjects was positive for GAD 65 antibodies (1%). The results suggest that a single GAD 65 antibody test may have a higher sensitivity for predicting IDDM than a test for islet cell cytoplasmic antibodies, but that a combined positive test for both antibodies increases the specificity for predicting IDDM over a period of 11.5 years.

Journal

Diabetologia – Springer Journals

Published: Sep 1, 1994

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