[Evaluation of the importance of antibodies against islet cells (ICA) and Glutamate Decarboxylase(anti-GAD) for determining prognosis of diabetes type 1 in the Polish population--5 year observation].
It was recently shown that there are significant differences between the frequencies of antibodies against pancreatic islet cell antigens (ICA, GADA) in the first degree relatives of IDDM patients in different regions of Poland. There are however no published studies concerning their predictive value in the development of IDDM in the Polish population. The aim of the present study was to evaluate the PPV (positive predictive value) of ICA and GADA antibodies and to analyse diabetes-free survival in association with titre, antibodies co-existence and relatives age in the Polish population. The study was performed in 225 first degree relatives of IDDM patients with ICA and/or GADA and 100 relatives without antibodies, in whom ICA and/or GADA were performed in 1993-1994. We have observed significantly lower percentages of diabetes-free survival in subjects with ICA > 20 JDF in comparison to relatives without ICA or with ICA < 20 JDF. The highest predictive value for diabetes type 1 development was associated with the ICA > 80 JDF and with the co-existence of ICA--20-79 JDF and GADA (+). There was also a statistically lower diabetes-free survival in first degree relatives (with ICA > 20 JDF) older than 20 years of age in comparison to the younger subjects. Detection of 2 antibodies: ICA and GADA made it possible to identify 80% of first degree relatives who have developed diabetes type 1 in the following 5-6 years, this suggests that the combined measurement of ICA and GADA could be a useful marker in screening for diabetes type 1 in first degree relatives of IDDM subjects in the Polish population. For the diabetes type 1 risk assessment in relatives with ICA > 20 JDF the age of the studied subjects should be taken into consideration.
Kretowski
A
A
Klinika Endokrynologii AM w Białymstoku. akretows@amb.ac.bialystok.pl
Szelachowska
M
M
Kinalska
I
I
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology*; D015993:Life Tables; D008297:Male; D011044:Poland; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity
D001323:Autoantibodies; C024211:islet cell antibody; D005968:Glutamate Decarboxylase