Elsevier

The Lancet

Volume 335, Issue 8682, 20 January 1990, Pages 147-149
The Lancet

CLINICAL PRACTICE
Quantification of islet-cell antibodies and prediction of insulin-dependent diabetes

https://doi.org/10.1016/0140-6736(90)90013-UGet rights and content

Abstract

The sensitivity and predictive value of islet-cell antibodies (ICA) for the future onset of insulin-dependent diabetes mellitus (IDDM) were determined in 719 first-degree relatives of IDDM patients. ICA were quantified in Juvenile Diabetes Foundation (JDF) units, by indirect immunofluorescence in serum samples taken during prospective follow-up of up to 10·5 years. The threshold of ICA detection was 4 JDF units. ICA were detected in the first sample of 26 (3·3%) of the relatives, compared with 12 (2·2%) of 540 controls (298 blood donors and 242 healthy children). ICA were detected in follow-up samples from a further 14 relatives. IDDM developed in 14 (35%) of the 40 relatives with detectable ICA at any time and in 2 (0·3%) relatives without detectable ICA. In all 5 relatives with peak ICA levels above 80 JDF units IDDM developed within follow-up of 7 years; survival without IDDM at 10 years was 27% among relatives with peak ICA levels of 20-80 JDF units and 82% for peak ICA levels of 4-20. The predictive value for IDDM development within 10 years ranged from 40% (threshold 4 JDF units) to 100% (80 JDF units) and the sensitivity from 31% (80 JDF units) to 88% (4 JDF units).

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