Pancreatic autoantibodies in Italian patients with newly diagnosed type 1 diabetes mellitus under the age of 20 years.
We analyzed 97 children and young persons (< 20 years of age) with newly diagnosed diabetes for antibodies to islet cells (ICAs), glutamic acid decarboxylase (GADAbs), second-islet antigen (IA2Abs), and insulin (IAAs) in order to evaluate the prevalence of immune-mediated type 1 diabetes, as well as to recognize which autoantibody combination is better associated with the disease. A positive result for one or more diabetes-related antibodies evaluated was found in 92 children (94.8%): 41 females (95.3%) and 51 males (94.4%). With regard to single autoantibody testing, ICA levels were found to be positive in 84 patients (86.6%), GADAbs in 71 (73.2%), IA2Abs in 60 (61.8%), and IAAs in 51 (52.6%) patients. Combining the determination of at least two autoantibodies, ICAs and/or GADAbs were more frequently detectable than other antibody combinations, being positive in 89 patients (91.8%). Our data indicate that the vast majority of cases of type 1 diabetes in children may be considered as immune-mediated, that multiple autoantibody analysis improves identification of the disease, and that first-level screening is provided by the combined detection of ICAs and GADAbs.
Betterle
C
C
Department of Medical and Surgical Sciences, University of Padova, Italy. corrado.betterle@unipd.it
Fusari
A
A
Presotto
F
F
Dal Pra
C
C
Pedini
B
B
Lazzarotto
F
F
Zanchetta
R
R
D000293:Adolescent; D017668:Age of Onset; D001323:Autoantibodies / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000276:immunology*; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology*; D007558:Italy; D008297:Male; D011863:Radioimmunoassay; D011869:Radioligand Assay
D001323:Autoantibodies