Natural history of islet cell antibodies during the clinical period of type 1 diabetes. High titres at diagnosis are associated with longer persistence.
The natural history of islet cell antibodies (ICA), using standardized Juvenile Diabetes Foundation (JDF) units, was studied for two years in 64 type 1 (insulin dependent) diabetic patients, aged 7-45 years prospectively from clinical onset. While ICA were present among 44/64 (68.8%) of the newly diagnosed patients, only 9.3% remained positive at 24 months. The only factor which showed significant predictive value for ICA survival was high initial JDF ICA titres: Maximal persistence of ICA was observed in patients with 80 JDF units at diagnosis (100% at 12 and 24 month). This persistence was lower in patients with 40 JDF units at diagnosis (77% at 12 month, 40% at 24 month) and the lowest for patients with 5 JDF at diagnosis (14% at 12 month, 0% at 15 month). 14/20 (70%) of patients negative for the ICA test at diagnosis became positive during follow-up, but always with a low titre (5-10 JDF units) and for a short period (3-6 months). It is concluded that initial titre is the most important variable in predicting the maintenance of ICA during the first two years of clinical type 1 diabetes.
Goday
A
A
Endocrinology and Diabetes Unit, Hospital Clinic, Barcelona, Spain.
Fernandez
J
J
Gonzalez-Clemente
J M
JM
Ferrer
J
J
Usach
E
E
Gomis
R
R
Vilardell
E
E
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D005455:Fluorescent Antibody Technique; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
D001323:Autoantibodies; D006442:Glycated Hemoglobin; C024211:islet cell antibody