An important minority of prediabetic first-degree relatives of type 1 diabetic patients derives from seroconversion to persistent autoantibody positivity after 10 years of age
| Autor: | Vermeulen, Isabel, Weets, I, Costa, O, Asanghanwa, M, Verhaeghen, K, Decochez, K, Ruige, J, Casteels, Kristina, Wenzlau, J, Hutton, JC, Pipeleers, DG, Gorus, FK, Belgian Diabetes Registry |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Time Factors Adolescent Endocrinology Diabetes and Metabolism Population 030209 endocrinology & metabolism Zinc Transporter 8 Article Disease-Free Survival Prediabetic State 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Epidemiology Internal Medicine Medicine Humans Insulin Prediabetes Seroconversion First-degree relatives education Child Cation Transport Proteins 030304 developmental biology Autoantibodies Family Health 0303 health sciences Type 1 diabetes education.field_of_study business.industry Glutamate Decarboxylase Autoantibody Age Factors medicine.disease 3. Good health Diabetes Mellitus Type 1 Child Preschool Immunology Female business |
| Popis: | The appearance of autoantibodies (Abs) before diabetes onset has mainly been studied in young children. However, most patients develop type 1 diabetes after the age of 15 years. In first-degree relatives aged under 40 years, we investigated the frequency of seroconversion to (persistent) Ab positivity, progression to diabetes and baseline characteristics of seroconverters according to age.Abs against insulin (IAA), glutamate decarboxylase (GADA), insulinoma-associated protein 2 (IA-2A) and zinc transporter 8 (ZnT8A) were measured during follow-up of 7,170 first-degree relatives.We identified 379 (5.3%) relatives with positivity for IAA, GADA, IA-2A and/or ZnT8A (Ab(+)) at first sampling and 224 (3.1%) at a later time point. Most seroconversions occurred after the age of 10 years (63%). During follow-up, Abs persisted more often in relatives initially Ab(+) (76%) than in seroconverters (53%; p0.001). In both groups diabetes developed at a similar pace and almost exclusively with Ab persistence (136 of 139 prediabetic individuals). For both groups, progression was more rapid if Abs appeared before the age of 10 years. Baseline characteristics at seroconversion did not vary significantly according to age.Seroconversion to (persistent) Ab(+) occurs regardless of age. Although the progression rate to diabetes is higher under age 10 years, later seroconverters (up to age 40 years) have similar characteristics when compared with age-matched initially Ab(+) relatives and generate an important minority of prediabetic relatives, warranting their identification and, eventually, enrolment in prevention trials. |
| Databáze: | OpenAIRE |
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