Immunologic and genetic markers in insulin-dependent diabetes mellitus (type 1) in an Argentine population.
The objective was to evaluate the prevalence and association of several markers (islet cell antibodies: ICA, insulin autoantibodies: IAA, glutamic acid decarboxylase antibodies: GADA and ICA512 antibodies: ICA512A) along with HLA DQB1 genotype in type 1 diabetes mellitus of recent onset, including siblings and individuals without any history of this disease, in an Argentine population. A total of 79 children with type 1 diabetes mellitus of recent onset were studied, as well as 79 control children, and 68 healthy siblings of type 1 diabetic cases. IAA, ICA, GADA, ICA512A and HLA DQB1 alleles were determined. Sensitivity was 67.1% for ICA, 36.7% for IAA, 74.6% for GADA and 63.4% for ICA512A. None of the control subjects was positive for the immunological markers. Combined sensitivity of ICA-IAA-GADA was 89.8%, similar to the ICA512A-GADA (87.3%) or ICA512A-GADA-IAA combination (91.1%). GADA correlated positively with ICA, but no such correlation was found between IAA, ICA512A and ICA. IAA correlated negatively and GADA positively with age. IAA was associated to DQB1*0201, whereas ICA and ICA512A associated to DQB1*0302. Among siblings, 3/68 (4.4%) were positive for IAA and a single case (1.5%) was positive for GADA and one for ICA512A. Our findings show that the combination of multiple tests increases the sensitivity for prediction, with the ICA512A-GADA combination proving highly sensitive and equivalent to other proposed combinations, such as ICA-IAA-GADA.
Krochik
A G
AG
Servicio de Nutrición, Hospital Nacional de Pediatría Juan P. Garrahan, Buenos Aires.
Mazza
C S
CS
Valdez
S N
SN
Stumpo
R R
RR
Papouchado
M L
ML
Iacono
R F
RF
Cardoso Landaburu
A C
AC
Sica
M P
MP
Ozuna
B
B
Poskus
E
E
D000293:Adolescent; D000328:Adult; D001118:Argentina; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics / Q000276:immunology*; D005260:Female; D005455:Fluorescent Antibody Technique; D005819:Genetic Markers; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007223:Infant; D007515:Islets of Langerhans / Q000276:immunology; D008297:Male; D012680:Sensitivity and Specificity
D001323:Autoantibodies; D015415:Biomarkers; D005819:Genetic Markers; D006680:HLA Antigens; D005968:Glutamate Decarboxylase