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Islet cell autoantibody levels after the diagnosis of young adult diabetic patients
Author(s) -
Jensen R.,
Gilliam L.,
Torn C.,
LandinOlsson M.,
Palmer J.,
Åkesson K.,
Kockum I.,
Lernmark B.,
Karlsson A. F.,
Lynch K. F.,
Breslow N.,
Lernmark Å.,
Sundkvist G.
Publication year - 2007
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2007.02235.x
Subject(s) - medicine , odds ratio , autoantibody , islet , confidence interval , diabetes mellitus , type 1 diabetes , gastroenterology , incidence (geometry) , endocrinology , immunology , antibody , physics , optics
Aims The aim was to determine the course of islet cell antibodies [glutamate decarboxylase (GADA), tyrosine phosphatase‐like islet antigen 2 (IA‐2A) and islet cell (ICA)] after the diagnosis of the diabetic patient. Methods The Diabetes Incidence Study in Sweden (DISS) attempted to prospectively enrol all newly diagnosed diabetic patients aged 15–34 years during 1992 and 1993. C‐peptide and autoantibody levels were determined from venous blood samples at diagnosis and again at yearly intervals for 6 years. Results After the first year, the odds of remaining GADA positive decreased by 9% per year [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.85–0.96] while the mean GADA index remained unchanged ( = 0.8, P = 0.37). There was no change in the percentage of subjects testing IA‐2A positive after the first year ( = 0.1, P = 0.75). However, the mean index decreased 0.04 per year (95% CI: 0.03–0.05)—a 7.9% decline (95% CI: 5.4–10.4%). The odds of a subject testing positive for ICA decreased by 24% per year (OR = 0.76, 95% CI = 0.70–0.82). The mean ICA levels decreased 0.75 per year (95% CI: 0.66–0.84)—a 16.4% decline (95% CI: 14.1–18.6%). The rate of change in titres for all three autoantibodies was independent of gender, human leucocyte antigen genotype and C‐peptide status. Conclusions GADA levels remained high while ICA levels declined. In contrast to a previous study, we found that the proportion of IA‐2A subjects remaining positive did not decrease after the first year, while the average index decreased slightly.