Diabetologia

, Volume 43, Issue 2, pp 203–209

Islet autoimmunity in infants with a Type I diabetic relative is common but is frequently restricted to one autoantibody

Authors

  • P. G. Colman
    • Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Victoria, Australia
  • C. Steele
    • Burnet Clinical Research Unit, Walter and Eliza Hall Institute of Medical Research, Royal Melbourne Hospital, Victoria, Australia
  • J. J. Couper
    • Women's and Children's Hospital, University of Adelaide, Adelaide, Australia Department of Diabetes and Endocrinology,
  • S. J. Beresford
    • Women's and Children's Hospital, University of Adelaide, Adelaide, Australia Department of Diabetes and Endocrinology,
  • T. Powell
    • Women's and Children's Hospital, University of Adelaide, Adelaide, Australia Department of Diabetes and Endocrinology,
  • K. Kewming
    • Department of Pathology, The Royal Melbourne Hospital, Victoria, Australia
  • A. Pollard
    • Women's and Children's Hospital, University of Adelaide, Adelaide, Australia Department of Diabetes and Endocrinology,
  • S. Gellert
    • Department of Pathology, The Royal Melbourne Hospital, Victoria, Australia
  • B. Tait
    • Department of Pathology, The Royal Melbourne Hospital, Victoria, Australia
  • M. Honeyman
    • Walter and Eliza Hall Institute of Medical Research, The Royal Melbourne Hospital, Victoria, Australia
  • L. C. Harrison
    • Walter and Eliza Hall Institute of Medical Research, The Royal Melbourne Hospital, Victoria, Australia
Article

DOI: 10.1007/s001250050030

Cite this article as:
Colman, P., Steele, C., Couper, J. et al. Diabetologia (2000) 43: 203. doi:10.1007/s001250050030

Abstract

Aims/hypothesis. To determine the sequence of development of islet autoantibodies and their relation to HLA genes in infants at risk for Type I diabetes followed from birth.¶Methods. We followed 357 (189 male, 168 female) infants, with a first degree relative with Type I diabetes for a mean of 3 years from birth. Human leukocyte antigen typing and assays for insulin autoantibodies (IAA), glutamic acid decarboxylase antibodies (GADAb) and tyrosine phosphatase IA2 (IA2Ab) antibodies were done on cord blood, and venous blood was sampled every 6 months for IAA, GADAb and IA2Ab.¶Results. We did not find any antibodies in 263 (73 %) infants; 50 (14 %) were positive for a single antibody once, 19 (5 %) for a single antibody more than once and 25 (7 %) for two or more antibodies. Of the latter, 10 (2.8 % overall) were persistently positive; they had higher frequencies of HLA DR4 (p < 0.01) and HLA DR3, 4 (p < 0.05). Of the group persistently positive for two or more antibodies four infants developed diabetes. Insulin autoantibodies were the first ones to develop in 64 % of infants with two or more antibodies.¶Conclusion/interpretation. Infants with high risk HLA-DR alleles and multiple antibodies at high risk for diabetes were identified. A much larger group of infants had transient low level increases usually of a single antibody. Whereas transient low level positivity could be attributed to difficulties with assay technique and cut off levels for normality, the results overall support the phenomenon of transient ’self limited' islet autoimmunity in at risk infants. [Diabetologia (2000) 43: 203–209]

Keywords Pre-clinical Type I diabetes, infants, insulin autoantibodies, GAD antibodies, IA2 antibodies, HLA.

Copyright information

© Springer-Verlag Berlin Heidelberg 2000