Publication
Title
Screening for insulinoma antigen 2 and zinc transporter 8 autoantibodies : a cost-effective and age-independent strategy to identify rapid progressors to clinical onset among relatives of type 1 diabetic patients
Author
Institution/Organisation
Belgian diabet Registry
Abstract
In first-degree relatives of type 1 diabetic patients, we investigated whether diabetes risk assessment solely based on insulinoma antigen 2 (IA-2) and zinc transporter 8 (ZnT8) antibody status (IA-2A, respectively, ZnT8A) is as effective as screening for three or four autoantibodies [antibodies against insulin (IAA), glutamate decarboxylase 65 kDa (GAD) glutamate decarboxylase autoantibodies (GADA) and IA-2A with or without ZnT8A] in identifying children, adolescents and adults who progress rapidly to diabetes (within 5 years). Antibodies were determined by radiobinding assays during follow-up of 6444 siblings and offspring aged 039 years at inclusion and recruited consecutively by the Belgian Diabetes Registry. We identified 394 persistently IAA(+), GADA(+), IA-2A(+) and/or ZnT8A(+) relatives (6.1%). After a median follow-up time of 52 months, 132 relatives developed type 1 diabetes. In each age category tested (0-9, 10-19 and 20-39 years) progression to diabetes was significantly quicker in the presence of IA-2A and/or ZnT8A than in their joint absence (P < 0.001). Progression rate was age-independent in IA-2A(+) and/or ZnT8A(+) relatives but decreased with age if only GADA and/or IAA were present (P = 0.008). In the age group mainly considered for immune interventions until now (1039 years), screening for IA-2A and ZnT8A alone identified 78% of the rapid progressors (versus 75% if positive for >= 2 antibodies among IAA, GADA, IA-2A and ZnT8A or versus 62% without testing for ZnT8A). Screening for IA-2A and ZnT8A alone allows identification of the majority of rapidly progressing prediabetic siblings and offspring regardless of age and is more cost-effective to select participants for intervention trials than conventional screening.
Language
English
Source (journal)
Clinical and experimental immunology. - Oxford
Publication
Oxford : 2013
ISSN
0009-9104
Volume/pages
171:1(2013), p. 82-90
ISI
000312160800011
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
[E?say:metaLocaldata.cgzprojectinf]
Prevention of betacelldestruction in type 1 diabetic patients and their high-risk relatives.
Beta cell function in (pre)type 1 diabetes.
BETACELLTHERAPY: Beta Cell Therapy in Diabetes
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 28.02.2013
Last edited 19.08.2017
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