The epidemiology of diabetes in Swedish children 0?14 years ? a six-year prospective study

Dahlquist, Gisela; Blom, L.; Holmgren, Gösta; Hägglöf, Bruno; Larsson, Yngve; Sterky, G; Wall, Stig

doi:10.1007/bf00291068

Cited by 197 publications

(154 citation statements)

References 38 publications

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“…ICA were highly predictive in this context, and their predictive diagnostic value could be enhanced by combined analysis with further beta-cell autoantibodies [6±9]. Although a positive family history of Type I diabetes is a risk factor for the disease, some 90 % of cases have no affected first-degree relative [10]. The present challenge is to achieve predictive diagnostic power in the general population, although the overall risk of Type I diabetes is considerably lower than in subjects with a family history of diabetes.…”

Section: : 661±670]mentioning

confidence: 99%

Karlsburg Type I diabetes risk study of a general population: frequencies and interactions of the four major Type I diabetes-associated autoantibodies studied in 9419 schoolchildren

et al. 1999

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Section: : 661±670]mentioning

confidence: 99%

Karlsburg Type I diabetes risk study of a general population: frequencies and interactions of the four major Type I diabetes-associated autoantibodies studied in 9419 schoolchildren

et al. 1999

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“…Furthermore, susceptibility to develop diabetes is associated with certain MHC-class II haplotypes [6] and analysis of both HLA haplotypes and autoantibodies provide a test of high predictive value in family members of IDDM patients [3,7]. Since most new cases of [DDM involve individuals without a first degree relative with the disease [8,9], predictive meth-ods need to be easily applicable to analyses of the general population.…”

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confidence: 99%

Value of antibodies to GAD65 combined with islet cell cytoplasmic antibodies for predicting IDDM in a childhood population

Aanstoot

Sigurdsson²,

Jaffe

et al. 1994

Diabetologia

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SummaryThe value of a test for islet cell cytoplasmic antibodies together with a test for GAD6s antibodies to predict the subsequent development of diabetes over a period of 11.5 years was assessed in an open childhood population comprising 2,805 individuals. A single serum sample was obtained from each individual between 1975 and 1977 and screened for islet cell cytoplasmic antibodies for which eight individuals were positive (0.29 %). During the average follow-up period of 11.5 years, four of eight islet cell antibody positive and three islet cell antibody negative individuals developed clinical diabetes. Sera from all individuals, who were islet cell antibody positive and/ or developed diabetes (total of 11) and from 100 randomly selected control subjects were analysed for GAD65 antibodies. Six of eight islet cell antibody positive individuals were GAD65 antibody positive including all four who subsequently developed IDDM. Furthermore, one of the three islet cell antibody negative individuals who developed IDDM was GAD65 antibody positive both in 1976 and in 1989. Thus, a positive test for GAD6s antibodies alone correctly predicted diabetes in five of seven children, who developed the disease. Only one of the children, who developed diabetes was positive for insulin autoantibodies and this individual was also positive for islet cell cytoplasmic antibodies and GAD65 antibodies. One of the 100 control subjects was positive for GAD6s antibodies (1%). The results suggest that a single GAD65 antibody test may have a higher sensitivity for predicting IDDM than a test for islet cell cytoplasmic antibodies, but that a combined positive test for both antibodies increases the specificity for predicting IDDM over a period of 11.5 years. [Diabetologia (1994) 37: 917-924] Key words GAD65 antibodies, islet cell cytoplasmic antibodies, predictive value, IDDM in childhood.The destruction of pancreatic beta cells, which precedes the clinical onset of IDDM, is mediated by autoimmune mechanisms [1]. The presence of islet specific autoantibodies in the pre-diabetic period [2-4] is likely to reflect the ongoing autoimmune process, one that eventually leads to critical beta-cell depletion and insulin dependency. A major goal of diabetes research is to develop immune interventions that block or otherwise interfere with the destruction of beta cells and the development of clinical diabetes. Concomitant with this goal is the necessity for methods for early accurate identification of susceptible individuals [5]. Antibody assays that detect early signs of humoral autoimmunity associated with beta-cell destruction are obvious candidates for this purpose. Furthermore, susceptibility to develop diabetes is associated with certain MHC-class II haplotypes [6] and analysis of both HLA haplotypes and autoantibodies provide a test of high predictive value in family members of IDDM patients [3,7]. Since most new cases of [DDM involve individuals without a first degree relative with the disease [8, 9], predictive meth-

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“…This has been suggested as one explanation of the prominent peak in the incidence of Type 1 diabetes occurring at the time of the maximal growth spurt in both boys and girls [13,14]. It is therefore of interest to study whether rapid growth before puberty is also a risk factor for Type 1 diabetes in childhood.…”

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confidence: 99%

A high linear growth is associated with an increased risk of childhood diabetes mellitus

1992

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Summary. Insulin release and growth are intimately connected. The aim of the present study was to investigate height and weight in diabetic children from birth to onset of Type 1 (insulin-dependent) diabetes mellitus compared to that in referent children. Data on height and weight were collected from mailed questionnaires and from growth records obtained from the child health clinics and schools in 337 recentonset diabetic children, 0-14 years old, and from 517 age-, sex-, and geographically matched referent children. A total of 9002 paired height and weight observations were collected. The anthropometric development of the children was expressed as standard deviation scores using the National Center for Health Statistics/Centers for Disease Control (NCHS/CDC) growth reference material. On the average, the diabetic children were consistently taller than the referent children, a finding more pronounced among the boys. The diabetic boys were significantly taller from 7 to i years before the clinical onset of the disease, regardless of age at onset. A similar tendency was found for the girls. When mean height from 5 to 1 years before onset was used as a possible risk factor for diabetes, a linearly increasing trend in the odds ratio was found for diabetes in boys (odds ratio = 1.0; 1.57; 2.46 for height standard deviation score values < 0; 0-1 and > 1, respectively;p = 0.002 for trend). A similar, but statistically not significant, tendency was found for girls (odds ratio = 1.0; 1.44; 1.43). As regards height increment from birth similar trends in odds ratios were found. Weight-for-height was similar among diabetic and referent children of both sexes. We conclude that diabetic boys tend to be taller and grow faster than referent boys for several years preceding the disease. A similar, but not statistically significant tendency was found among diabetic girls. Our findings indicate that rapid linear growth is a risk factor for Type I diabetes in childhood, and may be either a promoter of Type i diabetes or else a marker of a physiological mechanism that affects both growth and the pathogenesis of Type 1 diabetes.

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The epidemiology of diabetes in Swedish children 0?14 years ? a six-year prospective study

Cited by 197 publications

References 38 publications

Karlsburg Type I diabetes risk study of a general population: frequencies and interactions of the four major Type I diabetes-associated autoantibodies studied in 9419 schoolchildren

Karlsburg Type I diabetes risk study of a general population: frequencies and interactions of the four major Type I diabetes-associated autoantibodies studied in 9419 schoolchildren

Value of antibodies to GAD65 combined with islet cell cytoplasmic antibodies for predicting IDDM in a childhood population

A high linear growth is associated with an increased risk of childhood diabetes mellitus

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