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Åke Lernmark

Principal investigator

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Glutamate decarboxylase-, insulin-, and islet cell-antibodies and HLA typing to detect diabetes in a general population-based study of Swedish children

Author

  • William A. Hagopian
  • Carani B. Sanjeevi
  • Ingrid Kockum
  • Mona Landin-Olsson
  • Allan E. Karlsen
  • Göran Sundkvist
  • Gisela Dahlquist
  • Jerry Palmer
  • Åke Lernmark

Summary, in English

Most autoimmune diabetes occurs in those without a diabetic relative, but few cases are identifiable prospectively. To model general population prediction, 491 consecutive newly diabetic children from all of Sweden were tested for autoantibodies to glutamate decarboxylase (GAD65ab), insulin (IAA), and islet cells (ICA), and for HLA-DQ genotypes by PCR; 415 matched control children were tested in parallel. GAD65ab sensitivity/specificity was 70/96%, versus 84/96% for ICA, 56/97% for IAA, 93/93% (any positive), 39/99.7% (all positive), and 41/99.7% (GAD65ab plus IAA). The latter's 25% predictive value was not improved by requiring concomitant high-risk HLA genotypes. GAD65ab were associated with DQA1*0501/B1*0201 (DQ2; P = 0.007) but not DQA1*0301/B1*0302 (DQ8), and IAA with DQA1*0301/B1*0302 (DQ8; P = 0.03) but not DQA1*0501/B1*0201 (DQ2). GAD65ab were more prevalent in females than males (79 vs. 63%; P < 0.0001) but did not vary with onset age nor season. Combining the three antibody assays yielded sufficient sensitivity for screening. GADab were relatively sensitive/specific for diabetes, but even with HLA marker combinations yielded predictive values insufficient for early immunointervention in the low-prevalence general population.

Department/s

  • Diabetes lab
  • Medicine, Lund
  • Department of Clinical Sciences, Lund
  • Department of Clinical Sciences, Malmö

Publishing year

1995-01-01

Language

English

Pages

1505-1511

Publication/Series

Journal of Clinical Investigation

Volume

95

Issue

4

Document type

Journal article

Publisher

Am Soc Clin Investig

Topic

  • Endocrinology and Diabetes
  • Pediatrics

Keywords

  • autoimmunity
  • GAD
  • IAA
  • insulin-dependent diabetes
  • prediction

Status

Published

Research group

  • Diabetes lab

ISBN/ISSN/Other

  • ISSN: 0021-9738