Jamiołkowska-Sztabkowska Milena, Noiszewska Klaudyna, Polkowska Agnieszka, Zasim Aneta, Trzebuchowski Stanisław, Głowińska-Olszewska Barbara, Anikiej Katarzyna, Nesterowicz Miłosz, Skorupska Magdalena, Bossowski Filip, Buczyńska Angelika, Hryniewicka Justyna, Dyszkiewicz Aleksandra, Łobacz Aleksandra, Trzonkowski Piotr, Krętowski Adam, Bossowski Artur
Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Bialystok, Poland.
Student Research Group by the Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Bialystok, Poland.
Diabetes Obes Metab. 2025 Sep;27(9):5108-5117. doi: 10.1111/dom.16560. Epub 2025 Jun 24.
Assessment of islet autoimmunity and presymptomatic type 1 diabetes (T1D) among children from the general population of North-Eastern Poland.
Venous blood samples have been collected from 3575 children aged 1-9 years and analysed in a stepwise procedure starting with 3 Screen Islet Cell Autoantibody ELISA and IAA ELISA. Next, samples found positive in either test were verified for individual autoantibodies. Children with confirmed islet cell autoimmunity were invited for the follow-up consisting of laboratory testing, metabolic staging and education.
Among tested children detailed antibody testing confirmed islet cell autoimmunity in 7.78% participants and 1.17% of the total number presented multiple positive islet autoantibodies (IAb). IAAs were the most frequently reported (50.75%), while IA-2As were the least frequent (8.4%). IAAs were observed more frequently in individuals with T1D family history (p = 0.04), and in children aged 1-3 years (p = 0.02). The frequency of IA2-As and ZnT8As increased with age (p = 0.035 and p = 0.02) and ZnT8As were observed more frequently in females (p = 0.024). The prevalence of multiple positive IAbs was almost 2.5-times higher in children with T1D family history than in other peers. One hundred and thirteen children participated in follow-up. Within individuals with dysglycaemia almost 67% presented a single autoantibody and two participants (1.77%) presented Stage 3 diabetes - both diagnosed before DKA occurred.
Results confirm the importance of screening for IAbs in general paediatric population as a method of prediction of T1D development. The study also shows that patients with a single positive islet autoantibody may have already developed dysglycaemia and therefore need monitoring.
评估波兰东北部普通人群中儿童的胰岛自身免疫及症状前1型糖尿病（T1D）情况。
采集了3575名1至9岁儿童的静脉血样本，并采用逐步检测程序进行分析，首先进行3项胰岛细胞自身抗体酶联免疫吸附测定（ELISA）和胰岛素自身抗体（IAA）ELISA检测。接下来，对任一检测呈阳性的样本进行单个自身抗体的验证。确诊胰岛细胞自身免疫的儿童被邀请参加随访，随访包括实验室检测、代谢分期和教育。
在接受检测的儿童中，详细的抗体检测证实7.78%的参与者存在胰岛细胞自身免疫，1.17%的总人数呈现多种阳性胰岛自身抗体（IAb）。IAA是报告频率最高的（50.75%），而胰岛抗原2自身抗体（IA-2A）频率最低（8.4%）。IAA在有T1D家族史的个体中更常见（p = 0.04），且在1至3岁儿童中更常见（p = 0.02）。IA-2A和锌转运体8自身抗体（ZnT8A）的频率随年龄增加（p = 0.035和p = 0.02），且ZnT8A在女性中更常见（p = 0.024）。有T1D家族史的儿童中多种阳性IAb的患病率几乎是其他同龄儿童的2.5倍。113名儿童参加了随访。在血糖异常的个体中，近67%呈现单一自身抗体，两名参与者（1.77%）呈现3期糖尿病——均在糖尿病酮症酸中毒（DKA）发生前确诊。
结果证实了在普通儿科人群中筛查IAb作为预测T1D发生发展方法的重要性。该研究还表明，单一阳性胰岛自身抗体的患者可能已经出现血糖异常，因此需要监测。
