title: Cord blood insulinoma-associated protein 2 autoantibodies are associated with increased risk of type 1 diabetes in the population-based Diabetes Prediction in Skåne study.
abstract: OBJECTIVE
  The aim of this study was to examine the effect of cord blood autoantibodies on the risk for type 1 diabetes in children followed prospectively from birth.
  
  
  METHODS
  The Diabetes Prediction in Skåne (DiPiS) study consists of 35,853 children from the general population born during 2000-2004. Samples were collected at birth and analysed for HLA genotypes and autoantibodies to glutamate decarboxylase 65 (GAD65), insulin and insulinoma-associated protein 2 (IA-2). After adjusting for HLA, sex, maternal age and parental type 1 diabetes, independent associations with risk of diabetes were assessed using multivariate Cox proportional hazards models.
  
  
  RESULTS
  In total, 151 children (0.4%) had developed type 1 diabetes by the end of 2013 at a median age of 5.8 years (0.8-12.2 years). In the multivariate analysis, the presence of IA-2 autoantibodies (IA-2A) in cord blood (HR 6.88, 95% CI 1.46,32.4; p = 0.003), but not maternal diabetes (HR 1.38, 95% CI 0.24,7.84; p = 0.71), was associated with risk of developing type 1 diabetes. No increased risk could be seen for the presence of autoantibodies to GAD65 or insulin.
  
  
  CONCLUSIONS
  Our study indicates that the presence of cord blood IA-2A superimposes maternal diabetes and other cord blood islet autoantibodies as a predictor of type 1 diabetes development in the child. These findings may be of significance for future screening and study protocols on type 1 diabetes prediction.
authors.affiliation: Department of Paediatrics, Kristianstad Central Hospital, JA Hedlunds väg 5, S-291 33, Kristianstad, Sweden, markus.lundgren@med.lu.se.
authors.forename: Markus
authors.initials: M
authors.lastname: Lundgren
authors.forename: Kristian
authors.initials: K
authors.lastname: Lynch
authors.forename: Christer
authors.initials: C
authors.lastname: Larsson
authors.forename: Helena
authors.initials: H
authors.lastname: Elding Larsson
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D005312:Fetal Blood / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8 / Q000276:immunology*; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D001323:Autoantibodies; D054635:Receptor-Like Protein Tyrosine Phosphatases, Class 8