Diabetologia

, Volume 37, Issue 9, pp 917–924 | Cite as

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

  • H. -J. Aanstoot
  • E. Sigurdsson
  • M. Jaffe
  • Y. Shi
  • S. Christgau
  • D. Grobbee
  • G. J. Bruining
  • J. L. Molenaar
  • A. Hofman
  • S. Baekkeskov
Originals

Summary

The value of a test for islet cell cytoplasmic antibodies together with a test for GAD65 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 GAD65 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 GAD65 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.

Key words

GAD65 antibodies islet cell cytoplasmic antibodies predictive value IDDM in childhood 

Abbreviations

CL

Confidence limits

GAD

glutamic acid decarboxylase

IAA

insulin autoantibodies

ICA

islet cell autoantibodies

IDDM

insulin-dependent diabetes mellitus

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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • H. -J. Aanstoot
    • 1
  • E. Sigurdsson
    • 2
  • M. Jaffe
    • 1
  • Y. Shi
    • 1
  • S. Christgau
    • 1
    • 2
  • D. Grobbee
    • 3
  • G. J. Bruining
    • 4
  • J. L. Molenaar
    • 5
  • A. Hofman
    • 3
  • S. Baekkeskov
    • 1
    • 2
  1. 1.Hormone Research Institute, Departments of Microbiology/Immunology and MedicineUniversity of CaliforniaSan FranciscoUSA
  2. 2.Hagedorn Research LaboratoryGentofteDenmark
  3. 3.Department of EpidemiologyErasmus University Medical SchoolRotterdamThe Netherlands
  4. 4.Departments of Pediatrics, Division of Congenital/Hereditary DiseasesErasmus University Medical School and Sophia Children's HospitalRotterdamThe Netherlands
  5. 5.Department of ImmunologyStichting Samenwerkende Delftse ZiekenhuizenDelftThe Netherlands

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