title: Quantification of islet-cell antibodies and prediction of insulin-dependent diabetes.
abstract: The sensitivity and predictive value of islet-cell antibodies (ICA) for the future onset of insulin-dependent diabetes mellitus (IDDM) were determined in 719 first-degree relatives of IDDM patients. ICA were quantified in Juvenile Diabetes Foundation (JDF) units, by indirect immunofluorescence in serum samples taken during prospective follow-up of up to 10.5 years. The threshold of ICA detection was 4 JDF units. ICA were detected in the first sample of 26 (3.3%) of the relatives, compared with 12 (2.2%) of 540 controls (298 blood donors and 242 healthy children). ICA were detected in follow-up samples from a further 14 relatives. IDDM developed in 14 (35%) of the 40 relatives with detectable ICA at any time and in 2 (0.3%) relatives without detectable ICA. In all 5 relatives with peak ICA levels above 80 JDF units IDDM developed within follow-up of 7 years; survival without IDDM at 10 years was 27% among relatives with peak ICA levels of 20-80 JDF units and 82% for peak ICA levels of 4-20. The predictive value for IDDM development within 10 years ranged from 40% (threshold 4 JDF units) to 100% (80 JDF units) and the sensitivity from 31% (80 JDF units) to 88% (4 JDF units).
authors.affiliation: Department of Immunology, University College, Middlesex School of Medicine, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Bonifacio
authors.forename: P J
authors.initials: PJ
authors.lastname: Bingley
authors.forename: M
authors.initials: M
authors.lastname: Shattock
authors.forename: B M
authors.initials: BM
authors.lastname: Dean
authors.forename: D
authors.initials: D
authors.lastname: Dunger
authors.forename: E A
authors.initials: EA
authors.lastname: Gale
authors.forename: G F
authors.initials: GF
authors.lastname: Bottazzo
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000032:analysis*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000235:genetics / Q000276:immunology* / Q000517:prevention & control; D005260:Female; D005455:Fluorescent Antibody Technique; D005500:Follow-Up Studies; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; C024211:islet cell antibody