TY - JOUR
T1 - Risk of progression to diabetes of low titer ICA-positive first-degree relatives of type I diabetics in southern Germany
AU - Ziegler, Anette G.
AU - Baumgartl, Hans J.
AU - Standl, Eberhard
AU - Mehnert, Hellmut
N1 - Funding Information:
The authors are greatly indebted to Prof Dr H. Kolb, Dfisseldorf, for providing the ICA determinations and to Dr T. Lander, who initiated this study. The valuable cooperation with the immunological laboratory of Prof G. S. Eisenbarth, Joslin Diabetes Center, Boston, USA, is also highly appreciated. We gratefully acknowledge the technical support of U. Helwig, I. Reske, G. Ede, and M. Grinbergs. This work was supported by the Deutsche Forschungsgemeinschaft, FRG.
PY - 1990/10
Y1 - 1990/10
N2 - In a prospective study to evaluate the prevalence and predictive potential of circulating cytoplasmatic islet cell antibodies (ICA) and competitive insulin autoantibodies (CIAA), we screened 406 non-diabetic first-degree relatives of patients with Type I diabetes mellitus (n=154 for CIAA). The prevalence of ICA was 2.5% (10/406) and of CIAA 0.6% (1/154) in ICA- and 10% (1/10) in ICA+ relatives at initial screening. The titer of ICA positivity in all relatives varied between 1:1 and 1:4. Values of elevated CIAA were 256 nU/ml of the CIAA+/ICA+, and 97 nU/ml of the CIAA+/ICA-relatives (normal range ≤39 nU/ml). Sera for repeat ICA and CIAA determination was obtained, and 70% of relatives were found to be again ICA+ after 1.5 years, 40% after 3 years, and 10% after 5.7 years. Both CIAA+ relatives were found to be again CIAA+ on follow-up. Intravenous glucose tolerance tests (IVGTT) were performed in all antibody-positive relatives. No decrease in first-phase insulin secretion (1+3 min) below the 1st percentile was observed in any of the ICA+ relatives during follow-up. No ICA+, but one CIAA+/ICA-relative had developed Type I diabetes after 5.6 years of follow-up. In summary, these results indicate that low titer ICA (<40 JDF units) are often transient and relatives with low titer ICA rarely progress to Type I diabetes. Elevated CIAA appear to be constant over time and associated with increased progression to overt diabetes.
AB - In a prospective study to evaluate the prevalence and predictive potential of circulating cytoplasmatic islet cell antibodies (ICA) and competitive insulin autoantibodies (CIAA), we screened 406 non-diabetic first-degree relatives of patients with Type I diabetes mellitus (n=154 for CIAA). The prevalence of ICA was 2.5% (10/406) and of CIAA 0.6% (1/154) in ICA- and 10% (1/10) in ICA+ relatives at initial screening. The titer of ICA positivity in all relatives varied between 1:1 and 1:4. Values of elevated CIAA were 256 nU/ml of the CIAA+/ICA+, and 97 nU/ml of the CIAA+/ICA-relatives (normal range ≤39 nU/ml). Sera for repeat ICA and CIAA determination was obtained, and 70% of relatives were found to be again ICA+ after 1.5 years, 40% after 3 years, and 10% after 5.7 years. Both CIAA+ relatives were found to be again CIAA+ on follow-up. Intravenous glucose tolerance tests (IVGTT) were performed in all antibody-positive relatives. No decrease in first-phase insulin secretion (1+3 min) below the 1st percentile was observed in any of the ICA+ relatives during follow-up. No ICA+, but one CIAA+/ICA-relative had developed Type I diabetes after 5.6 years of follow-up. In summary, these results indicate that low titer ICA (<40 JDF units) are often transient and relatives with low titer ICA rarely progress to Type I diabetes. Elevated CIAA appear to be constant over time and associated with increased progression to overt diabetes.
UR - http://www.scopus.com/inward/record.url?scp=0025081384&partnerID=8YFLogxK
U2 - 10.1016/S0896-8411(05)80029-0
DO - 10.1016/S0896-8411(05)80029-0
M3 - Article
C2 - 2252530
AN - SCOPUS:0025081384
SN - 0896-8411
VL - 3
SP - 619
EP - 624
JO - Journal of Autoimmunity
JF - Journal of Autoimmunity
IS - 5
ER -
