التفاصيل البيبلوغرافية
| العنوان: |
Progression likelihood score identifies substages of presymptomatic type 1 diabetes in childhood public health screening |
| المؤلفون: |
Weiss, Andreas, Zapardiel-Gonzalo, Jose, Voss, Franziska, Jolink, Manja, Stock, Joanna, Haupt, Florian, Kick, Kerstin, Welzhofer, Tiziana, Heublein, Anja, Winkler, Christiane, Achenbach, Peter, Ziegler, Anette-Gabriele, Bonifacio, Ezio |
| المساهمون: |
LifeScience Stiftung, Federal Ministry of Education and Research, Juvenile Diabetes Research Foundation International, Leona M. and Harry B. Helmsley Charitable Trust |
| المصدر: |
Diabetologia ; volume 65, issue 12, page 2121-2131 ; ISSN 0012-186X 1432-0428 |
| بيانات النشر: |
Springer Science and Business Media LLC |
| سنة النشر: |
2022 |
| مصطلحات موضوعية: |
Endocrinology, Diabetes and Metabolism, Internal Medicine |
| الوصف: |
Aims/hypothesis The aim of this study was to develop strategies that identify children from the general population who have late-stage presymptomatic type 1 diabetes and may, therefore, benefit from immune intervention. Methods We tested children from Bavaria, Germany, aged 1.75–10 years, enrolled in the Fr1da public health screening programme for islet autoantibodies ( n =154,462). OGTT and HbA 1c were assessed in children with multiple islet autoantibodies for diagnosis of presymptomatic stage 1 (normoglycaemia) or stage 2 (dysglycaemia) type 1 diabetes. Cox proportional hazards and penalised logistic regression of autoantibody, genetic, metabolic and demographic information were used to develop a progression likelihood score to identify children with stage 1 type 1 diabetes who progressed to stage 3 (clinical) type 1 diabetes within 2 years. Results Of 447 children with multiple islet autoantibodies, 364 (81.4%) were staged. Undiagnosed stage 3 type 1 diabetes, presymptomatic stage 2, and stage 1 type 1 diabetes were detected in 41 (0.027% of screened children), 30 (0.019%) and 293 (0.19%) children, respectively. The 2 year risk for progression to stage 3 type 1 diabetes was 48% (95% CI 34, 58) in children with stage 2 type 1 diabetes (annualised risk, 28%). HbA 1c , islet antigen-2 autoantibody positivity and titre, and the 90 min OGTT value were predictors of progression in children with stage 1 type 1 diabetes. The derived progression likelihood score identified substages corresponding to ≤90th centile (stage 1a, n =258) and >90th centile (stage 1b, n =29; 0.019%) of stage 1 children with a 4.1% (95% CI 1.4, 6.7) and 46% (95% CI 21, 63) 2 year risk of progressing to stage 3 type 1 diabetes, respectively. Conclusions/interpretation Public health screening for islet autoantibodies found 0.027% of children to have undiagnosed clinical type 1 diabetes and 0.038% to have undiagnosed presymptomatic stage 2 or stage 1b type 1 diabetes, with 50% risk to develop clinical type 1 diabetes within 2 years. ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1007/s00125-022-05780-9 |
| DOI: |
10.1007/s00125-022-05780-9.pdf |
| DOI: |
10.1007/s00125-022-05780-9/fulltext.html |
| الإتاحة: |
https://doi.org/10.1007/s00125-022-05780-9Test |
| حقوق: |
https://creativecommons.org/licenses/by/4.0Test ; https://creativecommons.org/licenses/by/4.0Test |
| رقم الانضمام: |
edsbas.57E46B3D |
| قاعدة البيانات: |
BASE |
