Pauley Meghan E, Simmons Kimber M, Dong Fran, Yu Liping, Steck Andrea K, Rasmussen Cristy Geno, Frohnert Brigitte I, Rewers Marian J
Barbara Davis Center for Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
J Endocr Soc. 2025 May 20;9(8):bvaf095. doi: 10.1210/jendso/bvaf095. eCollection 2025 Aug.
Over half of all new cases of type 1 diabetes (T1D) are diagnosed in adults, yet the natural history of adult-onset T1D, particularly in nonfamilial populations, is not fully understood.
This study measured the prevalence of islet autoantibodies (IA) in adults without known diabetes and irrespective of T1D family history from Colorado (USA).
The Autoimmunity Screening for Kids study screened for IAs to insulin, glutamic acid decarboxylase (GADA), islet antigen-2, and zinc transporter 8 in 1087 adults without known diabetes [mean age 40.7 years with range 19.6-63.9 years, 63% non-Hispanic White (NHW), 10% with family history of T1D in a first-degree relative, and 78% female] from Colorado. IAs were measured using radiobinding assay and electrochemiluminescence detection methods.
In total, 3.86% of adults screened positive for any IA, 0.55% screened positive for multiple IAs, and 1.75% were positive for a single IA by both detection methods. Compared to NHW, those with Hispanic race/ethnicity were more likely to screen positive for a single IA (relative risk 2.32, 95% confidence interval 1.40, 3.84, = .001), but there was no difference in the risk of screening positive for multiple IAs when comparing across race/ethnicity. GADA was the most prevalent IA, found in 2.67% of adults.
IA prevalence was high in this sample of adults without known diabetes from Colorado. Further study is needed to fully characterize the risk of progression to clinical diabetes among adults who screen positive for IAs, particularly in nonfamilial populations.
超过一半的1型糖尿病（T1D）新发病例在成人中被诊断出来，但成人发病型T1D的自然病程，尤其是在非家族性人群中的自然病程，尚未完全了解。
本研究测量了美国科罗拉多州无已知糖尿病且与T1D家族史无关的成年人中胰岛自身抗体（IA）的患病率。
儿童自身免疫筛查研究对来自科罗拉多州的1087名无已知糖尿病的成年人[平均年龄40.7岁，范围19.6 - 63.9岁，63%为非西班牙裔白人（NHW），10%的一级亲属有T1D家族史，78%为女性]进行了胰岛素、谷氨酸脱羧酶（GADA）、胰岛抗原2和锌转运体8的IA筛查。使用放射结合测定法和电化学发光检测法测量IA。
总体而言，3.86%的成年人任何一种IA筛查呈阳性，0.55%的成年人多种IA筛查呈阳性，两种检测方法均显示1.75%的成年人单一IA呈阳性。与NHW相比，西班牙裔种族/族裔的人单一IA筛查呈阳性的可能性更高（相对风险2.32，95%置信区间1.40，3.84，P = 0.001），但在不同种族/族裔之间比较时，多种IA筛查呈阳性的风险没有差异。GADA是最常见的IA，在2.67%的成年人中被发现。
在科罗拉多州这个无已知糖尿病的成人样本中，IA患病率很高。需要进一步研究以全面描述IA筛查呈阳性的成年人，尤其是非家族性人群中进展为临床糖尿病的风险。
