The prediction of type 1 diabetes by multiple autoantibody levels and their incorporation into an autoantibody risk score in relatives of type 1 diabetic patients
- Author(s)
- Sosenko, JM; Skyler, JS; Palmer, JP; Krischer, JP; Yu, L; Mahon, J; Beam, CA; Boulware, DC; Rafkin, L; Schatz, D; Eisenbarth, G; Type 1 Diabetes TrialNet Study, Group; Diabetes Prevention Trial-Type 1 Study, Group;
- Details
- Publication Year 2013-09,Volume 36,Issue #9,Page 2615-20
- Journal Title
- Diabetes Care
- Publication Type
- Journal Article
- Abstract
- OBJECTIVE: We assessed whether a risk score that incorporates levels of multiple islet autoantibodies could enhance the prediction of type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: TrialNet Natural History Study participants (n = 784) were tested for three autoantibodies (GADA, IA-2A, and mIAA) at their initial screening. Samples from those positive for at least one autoantibody were subsequently tested for ICA and ZnT8A. An autoantibody risk score (ABRS) was developed from a proportional hazards model that combined autoantibody levels from each autoantibody along with their designations of positivity and negativity. RESULTS: The ABRS was strongly predictive of T1D (hazard ratio [with 95% CI] 2.72 [2.23-3.31], P < 0.001). Receiver operating characteristic curve areas (with 95% CI) for the ABRS revealed good predictability (0.84 [0.78-0.90] at 2 years, 0.81 [0.74-0.89] at 3 years, P < 0.001 for both). The composite of levels from the five autoantibodies was predictive of T1D before and after an adjustment for the positivity or negativity of autoantibodies (P < 0.001). The findings were almost identical when ICA was excluded from the risk score model. The combination of the ABRS and the previously validated Diabetes Prevention Trial-Type 1 Risk Score (DPTRS) predicted T1D more accurately (0.93 [0.88-0.98] at 2 years, 0.91 [0.83-0.99] at 3 years) than either the DPTRS or the ABRS alone (P </= 0.01 for all comparisons). CONCLUSIONS: These findings show the importance of considering autoantibody levels in assessing the risk of T1D. Moreover, levels of multiple autoantibodies can be incorporated into an ABRS that accurately predicts T1D.
- Publisher
- American DIabetes Association
- Research Division(s)
- Molecular Medicine
- Link To PubMed Central Version
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747899/
- Publisher's Version
- https://doi.org/10.2337/dc13-0425
- Terms of Use/Rights Notice
- Copyright © 2014 by the American Diabetes
Creation Date: 2014-03-11 12:01:06