ISSN:
1432-0428
Keywords:
Key words Autoimmune disease, Type 1 (insulin-dependent) diabetes mellitus, islet cell antibodies, autoimmune polyendocrinopathy, HLA-DR.
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary An 11-year prospective study was carried out in 180 non-diabetic patients with organ-specific autoimmune diseases to evaluate islet cell antibodies in predicting Type 1 (insulin-dependent) diabetes mellitus. Islet cell antibodies were characterised according to titres, persistence, complement-fixing ability, and pattern. During follow-up, 14 of 46 patients with islet cell antibodies persistently greater than 5 Juvenile Diabetes Foundation Units (JDF-U) (30.4 %), none of 23 with islet cell antibodies between 2.5 and 5 JDF-U or fluctuating, and 3 of 109 without islet cell antibodies (2.7 %), developed diabetes. The cumulative risk of developing diabetes was 70 %, 0 %, and 4 %, respectively. All the patients who developed diabetes were females. Eight progressed to insulin-dependence acutely, four showed a transient period of non-insulin-dependence, while two were still insulin-free. No difference was found in titres of islet cell antibodies for the risk of diabetes. Complement-fixing islet cell antibodies enhanced the cumulative risk for the disease in patients with conventional islet cell antibodies at low-middle (≥2.5–40 JDF-U), but not at high (≥80 JDF-U) titres. Forty-two patients with islet cell antibodies were investigated for the whole or the selective pattern. In the presence of the whole pattern the cumulative risk for diabetes rose to 100 %, while with the selective pattern it declined to 34 %. The whole pattern was found in 83 % of patients who developed Type 1 diabetes acutely. In patients with organ-specific autoimmune diseases, the whole islet cell antibody pattern greatly enhances the prediction for diabetes. [Diabetologia (1994) 37: 95–103]
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001250050078
Permalink
