Williams A J K, Bingley P J, Moore W P T, Gale E A M
Diabetes and Metabolism, Division of Medicine, University of Bristol, UK.
Diabetologia. 2002 Feb;45(2):217-23. doi: 10.1007/s00125-001-0749-6.
AIMS/HYPOTHESIS: First-degree relatives of patients with Type I (insulin-dependent) diabetes mellitus diagnosed at 20 years of age or under were screened for islet cell antibodies (ICA) in the course of recruitment to an international diabetes prevention trial. Our aim was to evaluate the influence of age, gender, proband characteristics and nationality on the prevalence of ICA and co-existence of autoantibodies to GAD, IA-2 and insulin.
A central laboratory screened samples from 10 326 non-diabetic relatives who were aged less than 40 years, from eight European countries for ICA. Antibodies to GAD and IA-2 were measured in all samples with ICA of 10 JDF units or more.
Overall, 8.9 % of relatives had ICA of 10 JDF units or more, 3.8 % with ICA of 20 JDF units or more. Of 921 relatives with ICA of 10 JDF units or more, 29 % had co-existing antibodies to GAD or IA-2 or both. ICA of 10 JDF units or more were more prevalent in males (10.8 %) than females (7.3 %). ICA with GAD or IA-2 antibodies or both were also more common in males (3.4 %) than females (1.9 %) and in relatives under 20 years of age (3.5 % vs 1.5 %). Multiple regression analysis showed nationality to be a determinant of ICA of 10 JDF units or more but not of ICA of 20 JDF units or more or of ICA with co-existing islet antibodies, and confirmed the importance of age and gender as determinants of islet autoimmunity.
CONCLUSIONS/INTERPRETATION: Relatives from different European countries have similar rates of islet autoimmunity despite wide variation in the background incidence of childhood diabetes, and male excess is equally evident in all populations. The male excess of ICA and islet autoimmunity over 10 years of age reflects the higher male incidence of Type I diabetes in this age group, and suggests that boys may be more likely than girls to develop islet autoimmunity during adolescence.
目的/假设：在一项国际糖尿病预防试验的招募过程中，对20岁及以下被诊断为I型（胰岛素依赖型）糖尿病患者的一级亲属进行胰岛细胞抗体（ICA）筛查。我们的目的是评估年龄、性别、先证者特征和国籍对ICA患病率以及GAD、IA - 2和胰岛素自身抗体共存情况的影响。
一个中心实验室对来自八个欧洲国家的10326名年龄小于40岁的非糖尿病亲属的样本进行ICA筛查。对所有ICA为10 JDF单位或更高的样本测量GAD和IA - 2抗体。
总体而言，8.9%的亲属ICA为10 JDF单位或更高，3.8%的亲属ICA为20 JDF单位或更高。在921名ICA为10 JDF单位或更高的亲属中，29%同时存在GAD或IA - 2抗体或两者都有。ICA为10 JDF单位或更高在男性（10.8%）中比女性（7.3%）更普遍。伴有GAD或IA - 2抗体或两者的ICA在男性（3.4%）中也比女性（1.9%）更常见，在20岁以下的亲属中（3.5%对1.5%）更常见。多元回归分析表明国籍是ICA为10 JDF单位或更高的一个决定因素，但不是ICA为20 JDF单位或更高或伴有共存胰岛抗体的ICA的决定因素，并证实了年龄和性别作为胰岛自身免疫决定因素的重要性。
结论/解读：尽管儿童糖尿病的背景发病率差异很大，但来自不同欧洲国家的亲属有相似的胰岛自身免疫率，并且男性占比过高在所有人群中同样明显。10岁以上男性ICA和胰岛自身免疫占比过高反映了该年龄组I型糖尿病男性发病率较高，这表明男孩在青春期可能比女孩更易发生胰岛自身免疫。
