Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, Colorado.
Pediatr Diabetes. 2019 Nov;20(7):909-914. doi: 10.1111/pedi.12902. Epub 2019 Aug 18.
The incidence of type 1 diabetes (T1D) is increasing, most notably in young children and in racial and ethnic minorities. Historically, screening for risk with T1D-associated antibodies has been limited to those with a family history, while up to 90% of newly diagnosed patients lack such a family history. To address the needs to screen diverse ethnic groups in the general population, we screened children for T1D-associated antibodies in the Denver, Colorado metro area at community health fairs.
Children attending health fairs from 2015 to 2018 were offered free T1D screening by measuring the four prototypical T1D-associated antibodies. A finger stick capillary puncture was performed to collect blood spots on filter paper. Dried blood spots (DBSs) were eluted and antibodies were measured using fluid-phase radio-binding assays.
At 39 health fairs, children were educated on the signs and symptoms of diabetes, and screened for T1D-associated antibodies (n = 478), which represented 90% of those that attended. Median age was 9.0 years (range of 1-18) with diverse ethnic backgrounds: 37% Hispanic, 31% Caucasian, 20% African American, and 12% other. Nine children screened positive for antibodies, single n = 8 and multiple n = 1, and confirmation with serum samples showed excellent correlation to the measurements from DBSs for antibodies directed against GAD, IA-2, and ZnT8 (P < .01 for each).
Screening for T1D risk at community health fairs using DBSs on filter paper is feasible and provides an avenue to screen children from ethnically diverse backgrounds.
1 型糖尿病（T1D）的发病率正在上升，尤其是在幼儿和少数族裔中。从历史上看，与 T1D 相关的抗体的风险筛查仅限于有家族病史的人群，而高达 90%的新诊断患者缺乏这种家族病史。为了满足在普通人群中筛查不同种族的需求，我们在科罗拉多州丹佛市的社区健康博览会上对儿童进行了 T1D 相关抗体筛查。
2015 年至 2018 年，在参加健康博览会的儿童中，通过测量四种典型的 T1D 相关抗体来提供免费的 T1D 筛查。使用手指刺穿毛细血管采集滤纸上的血斑。从干血斑（DBS）洗脱液中提取抗体，并使用液相结合放射结合测定法进行测量。
在 39 次健康博览会上，对儿童进行了糖尿病的症状和体征教育，并对 T1D 相关抗体进行了筛查（n = 478），占参加者的 90%。中位数年龄为 9.0 岁（范围为 1-18 岁），具有多种族裔背景：37%为西班牙裔，31%为白种人，20%为非裔美国人，12%为其他族裔。9 名儿童的抗体筛查呈阳性，单 n = 8，多 n = 1，与血清样本的确认显示，针对 GAD、IA-2 和 ZnT8 的抗体的 DBS 测量结果与血清样本的测量结果具有极好的相关性（每种抗体的 P <.01）。
使用滤纸上的 DBS 在社区健康博览会上筛查 T1D 风险是可行的，为筛查来自不同族裔背景的儿童提供了途径。
