Prediction of type 1 diabetes in Sardinian schoolchildren using islet cell autoantibodies: 10-year follow-up of the Sardinian schoolchildren type 1 diabetes prediction study
| Autor: | Fernanda, Velluzzi, Gianni, Secci, Vincenzo, Sepe, Catherine, Klersy, Marion, Shattock, Richard, Foxon, Marco, Songini, Stefano, Mariotti, Mattia, Locatelli, Gian Franco, Bottazzo, Andrea, Loviselli, A, Deplano |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Population 030209 endocrinology & metabolism Gastroenterology Sensitivity and Specificity 03 medical and health sciences Islets of Langerhans 0302 clinical medicine Endocrinology Diabetes mellitus Internal medicine Internal Medicine medicine Humans 030212 general & internal medicine education Child Autoantibodies Type 1 diabetes education.field_of_study geography geography.geographical_feature_category Schools business.industry 10 year follow up Glutamate Decarboxylase Islet cell autoantibodies Hazard ratio Autoantibody General Medicine medicine.disease Islet Prognosis Diabetes Mellitus Type 1 Italy Child Preschool Immunology Disease Progression Female Protein Tyrosine Phosphatases business Follow-Up Studies |
| Zdroj: | Acta diabetologica. 53(1) |
| ISSN: | 1432-5233 |
| Popis: | Stable genetic background makes individuals from the Mediterranean island of Sardinia ideal to define the predictive power of islet-related autoantibodies (IRAs): glutamic acid decarboxylase antibodies (GADA), tyrosine phosphatase-like antibodies (IA-2A), islet cell antibodies (ICA) to identify T1DM progressors. The aims of the present study were: (1) determination of IRAs reference limits in healthy non-diabetic Sardinian schoolchildren (SSc). (2) Predictive power evaluation of IRAs as single or combined determination to identify islet to identify T1DM progressors. Between 1986 and 1994, 8448 SSc were tested for IRAs. All were followed up for 10 years. The predictive power of single or combination of IRAs was determined as hazard ratio (HR), sensitivity, specificity, area under the ROC curve, negative and positive predictive value (NPV, PPV). All 43 progressors to T1DM, but three showed at least one autoantibody positivity. HR for any single-autoantibody positivity was 55.3 times greater when compared to SSc negative for all IRAs. Any single autoantibody performed at least 64.9 % sensitivity with PPV always lower than 16 %. The best performing combination was ICA, plus IA-2A (showing 52.6 % sensitivity, 99.8 % specificity, 0.76 area under the ROC curve, 51.3 % PPV and 99.8 % NPV. Determination of IRAs reference limits in healthy SSc by standard statistical methods is crucial to establish the power of IRAs as progression markers to T1DM. Our data offer a solid rationale for future testing of ICA and IA-2A as routine laboratory markers to identify individuals at high risk of T1DM in the general population. |
| Databáze: | OpenAIRE |
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