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Can islet cell antibodies predict IDDM in the general population?
P J Bingley1, E Bonifacio, M Shattock
1Department of Diabetes and Metabolism, St. Bartholomew's Hospital, London, United Kingdom.
Diabetes Care
|January 1, 1993
Summary
Islet cell antibodies (ICAs) are common in children but rarely lead to diabetes. While ICAs alone have limited predictive value, combining tests may improve diabetes risk prediction.
Area of Science:
- Pediatric Endocrinology
- Immunology
- Diabetes Research
Background:
- Islet cell antibodies (ICAs) are markers of autoimmune activity.
- Understanding ICA prevalence and prognostic significance is crucial for early diabetes detection.
Purpose of the Study:
- To assess the prognostic value of ICAs in children without a family history of Type 1 diabetes (T1D).
- To determine the prevalence of ICAs in a general child population and compare it to siblings of diabetic children.
Main Methods:
- Prevalence of ICAs was measured in 2925 English schoolchildren (ages 9-13) and 274 age-matched siblings of diabetic children.
- Risk of progression to diabetes within 10 years was estimated for both groups.
Main Results:
- ICAs were found in 2.8% of schoolchildren and 6.6% of siblings at a threshold of >= 4 JDF U.
- The estimated cumulative risk of developing diabetes by age 21 was 13 times higher in siblings (2.8%) compared to schoolchildren (0.21%).
Conclusions:
- ICAs are surprisingly common in English schoolchildren.
- A small proportion of children with ICAs will progress to diabetes, indicating limited predictive value alone.
- Combining multiple predictive tests may enhance diabetes prediction accuracy in the general population.