Sensitivity at diagnosis of combined beta-cell autoantibodies in insulin-dependent diabetic children. French Registry of IDDM in Children Study Group.
The purpose of this study was to test for the presence (alone or in combination) of 4 autoantibodies directed against beta cells in the sera of children at diagnosis of the overt clinical phase of insulin-dependent diabetes mellitus. Children recorded in 1989 in the population-based French Registry of Incidence of Insulin-Dependent Diabetes Mellitus were included in the present study. One hundred and thirty-eight sera were tested for islet cell antibodies (ICA), insulin autoantibodies (IAA) and antibodies against glutamic acid decarboxylase (GAD-Ab) and tyrosine phosphatase (IA2-Ab). IAA showed significantly lower sensitivity (36%) than the other antibodies (ICA: 84%; GAD-Ab: 74%; IA2-Ab: 81%). In the age-range of the registry, the prevalence rates for the 4 antibodies were not significantly affected by age. IAA and GAD-Ab were significantly associated with ICA, whereas GAD-Ab and/or IA2-Ab was(were) associated with 93% sensitivity at diagnosis. Sensitivity was 100% with the 4 antibodies combined. No significant association was found between the antibodies and HLA DR phenotypes. This study shows that a combination of the 4 major autoantibodies allows all children with insulin-dependent diabetes to be identified.
Ongagna
J C
JC
INSERM U 457, Hôpital Robert Debré, Paris, France.
Levy-Marchal
C
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D019084:Fluorescent Antibody Technique, Indirect; D005602:France / Q000453:epidemiology; D005968:Glutamate Decarboxylase / Q000276:immunology; D015803:HLA-DR3 Antigen / Q000032:analysis; D015804:HLA-DR4 Antigen / Q000032:analysis; D006801:Humans; D015994:Incidence; D007223:Infant; D007330:Insulin Antibodies / Q000097:blood*; D007515:Islets of Langerhans / Q000276:immunology*; D010641:Phenotype; D054562:Protein Tyrosine Phosphatase, Non-Receptor Type 1; D017027:Protein Tyrosine Phosphatases / Q000276:immunology; D011863:Radioimmunoassay; D012016:Reference Values; D012042:Registries; D012680:Sensitivity and Specificity
D001323:Autoantibodies; D015803:HLA-DR3 Antigen; D015804:HLA-DR4 Antigen; D007330:Insulin Antibodies; C024211:islet cell antibody; D054562:Protein Tyrosine Phosphatase, Non-Receptor Type 1; D017027:Protein Tyrosine Phosphatases; D005968:Glutamate Decarboxylase