Brief communication: early appearance of islet autoantibodies predicts childhood type 1 diabetes in offspring of diabetic parents.
BACKGROUND
The development of type 1 diabetes mellitus is preceded by autoimmunity against islet beta cells.


OBJECTIVE
To determine the risk for islet autoimmunity and childhood diabetes in offspring of affected parents.


METHODS
Prospective cohort study.


METHODS
German BABYDIAB study.


METHODS
1610 offspring of parents with type 1 diabetes.


METHODS
Autoantibodies to islet autoantigens were measured at 9 months, 2 years, 5 years, and 8 years of age.


RESULTS
By 5 years of age, the frequency of islet autoantibodies was 5.9% (95% CI, 4.6% to 7.2%), the frequency of multiple islet autoantibodies was 3.5% (CI, 2.5% to 4.5%), and the frequency of diabetes was 1.5% (CI, 0.9% to 2.1%). The risk for diabetes was highest in offspring with multiple autoantibodies (40% within 5 years vs. 3% in offspring with single autoantibodies; P = 0.005). Progression to multiple islet autoantibodies was fastest in children who were autoantibody positive by age 2 years (P < 0.001), and progression to diabetes was inversely related to the age of positivity for multiple autoantibodies (P = 0.02).


CONCLUSIONS
The findings are limited to childhood diabetes in affected families.


CONCLUSIONS
Childhood autoimmune diabetes is associated with autoimmunity that starts before 2 years of age.
Hummel
Michael
M
Diabetes Research Institute and Academic Hospital Schwabing, Munich, Germany.
Bonifacio
Ezio
E
Schmid
Sandra
S
Walter
Markus
M
Knopff
Annette
A
Ziegler
Anette-G
AG
D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000276:immunology*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007515:Islets of Langerhans / Q000276:immunology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
D001323:Autoantibodies