Article Text

PDF

Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes
  1. R Perchard1,2,
  2. D MacDonald3,
  3. J Say1,
  4. J Pitts2,
  5. S Pye3,
  6. J Allgrove1,
  7. K Banerjee2,
  8. R Amin4
  1. 1Department of Paediatrics, Royal London Hospital, London, UK
  2. 2Department of Paediatrics, Queens Hospital, Romford, UK
  3. 3Department of Immunology, Royal London Hospital, London, UK
  4. 4Clinical & Molecular Genetics Unit, UCL Institute of Child Health, London, UK
  1. Correspondence to Dr Rakesh Amin, Clinical Molecular and Genetis Unit, UCL Institute of Chlld Health, London rakesh.amin{at}ucl.ac.uk

Abstract

Objective We prospectively determined islet autoantibody status in children presenting with diabetes to a single UK region in relation to ethnicity.

Design 316 (68.0% non-white) children presenting with diabetes between 2006 and 2013 were tested centrally for islet cell autoantibodies (ICA) and glutamic acid decarboxylase autoantibodies (GAD-65) at diagnosis, and if negative for both, tested for insulin autoantibodies (IAA). The assay used to measure GAD-65 autoantibodies changed from an in-house to a standardised ELISA method during the study.

Results Even with use of the standardised ELISA method, 25.8% of children assigned a diagnosis of type 1 diabetes still tested negative for all three autoantibodies. 30% of children assigned a diagnosis of type 2 diabetes were autoantibody positive, and these had the highest glycated haemoglobin (HbA1c) levels at 12 months follow-up compared with other groups (p value for analysis of variance <0.001), although the sample size was small. Autoantibody positivity was similar between non-white and white children regardless of assay used (60.0% (n=129) vs 56.4% (n=57), χ2=0.9, p=0.35), as was mean GAD-65 autoantibody levels, but fewer non-white children had two or more autoantibodies detectable (13% (n=28) vs 27.7% (n=28), χ2=12.1, p=0.001).

Conclusions Islet autoantibody positivity was associated with a more severe phenotype, as demonstrated by poorer glycaemic control, regardless of assigned diabetes subtype. Positivity did not differ by ethnic group.

  • Endocrinology
  • Race and Health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

View Full Text

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.