Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes
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 glut...
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| Veröffentlicht in: | Archives of disease in childhood 2015-04, Vol.100 (4), p.348-352 |
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| creator | Perchard, R MacDonald, D Say, J Pitts, J Pye, S Allgrove, J Banerjee, K Amin, R |
| description | 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 |
| doi_str_mv | 10.1136/archdischild-2014-306542 |
| format | Article |
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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.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2014-306542</identifier><identifier>PMID: 25409982</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Adolescent ; Analysis ; Analysis of Variance ; Autoantibodies ; Autoantibodies - metabolism ; Child ; Child, Preschool ; Children ; Diabetes in children ; Diabetes Mellitus, Type 2 - ethnology ; Diabetes Mellitus, Type 2 - immunology ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique, Indirect ; Health aspects ; Humans ; Infant ; Infant, Newborn ; Islands of Langerhans ; Islets of Langerhans ; Islets of Langerhans - immunology ; Juvenile diabetes ; Male ; Phenotype ; Prospective Studies ; Risk factors</subject><ispartof>Archives of disease in childhood, 2015-04, Vol.100 (4), p.348-352</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b513t-e2be8c23934c694eae12b5e5702de4371179a693684001b0a3c54136635291983</citedby><cites>FETCH-LOGICAL-b513t-e2be8c23934c694eae12b5e5702de4371179a693684001b0a3c54136635291983</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://adc.bmj.com/content/100/4/348.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://adc.bmj.com/content/100/4/348.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,314,777,781,3183,23552,27905,27906,77349,77380</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25409982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Perchard, R</creatorcontrib><creatorcontrib>MacDonald, D</creatorcontrib><creatorcontrib>Say, J</creatorcontrib><creatorcontrib>Pitts, J</creatorcontrib><creatorcontrib>Pye, S</creatorcontrib><creatorcontrib>Allgrove, J</creatorcontrib><creatorcontrib>Banerjee, K</creatorcontrib><creatorcontrib>Amin, R</creatorcontrib><title>Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>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.</description><subject>Adolescent</subject><subject>Analysis</subject><subject>Analysis of Variance</subject><subject>Autoantibodies</subject><subject>Autoantibodies - metabolism</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Diabetes in children</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Diabetes Mellitus, Type 2 - immunology</subject><subject>Diagnosis</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Female</subject><subject>Fluorescent Antibody Technique, Indirect</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Islands of Langerhans</subject><subject>Islets of Langerhans</subject><subject>Islets of Langerhans - immunology</subject><subject>Juvenile diabetes</subject><subject>Male</subject><subject>Phenotype</subject><subject>Prospective Studies</subject><subject>Risk factors</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><recordid>eNqNkUtv1DAUhS0EokPhLyAv2QT8ih_LasSjolI3dG05zp2JKycebEfQf4-HFMSOrnxlfffo3HMQwpS8p5TLDy77aQzFTyGOHSNUdJzIXrBnaEeF1O1LiOdoRwjhndFaX6BXpdwTQpnW_CW6YL0gxmi2Q-66RKjYrTW5pYYhjQ-4VFfXgsOCHZ7XWEMHdVqCx3dfsY_hPPk0pVxxOuDfHjIs-JShQJNYjvhHqBMegxugQnmNXhxcLPDm8b1Ed58-ftt_6W5uP1_vr266oae8dsAG0J5xw4WXRoADyoYeekXYCIIrSpVx0nCpRbtjII77XrQsJO-ZoUbzS_Ru0z3l9H2FUu3cEoIY3QJpLZZqohVlivP_o1Irwlta_RNQKZRqrk1Duw09ugg2LD4tFX5Wn2KEI9h27P7WXgkqWvjKnHm98T6nUjIc7CmH2eUHS4k912z_rdmea7ZbzW317aOrdZhh_Lv4p9cG8A0Y5vuny_4C9d21RQ</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Perchard, R</creator><creator>MacDonald, D</creator><creator>Say, J</creator><creator>Pitts, J</creator><creator>Pye, S</creator><creator>Allgrove, J</creator><creator>Banerjee, K</creator><creator>Amin, R</creator><general>BMJ Publishing Group Ltd</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20150401</creationdate><title>Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes</title><author>Perchard, R ; MacDonald, D ; Say, J ; Pitts, J ; Pye, S ; Allgrove, J ; Banerjee, K ; Amin, R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b513t-e2be8c23934c694eae12b5e5702de4371179a693684001b0a3c54136635291983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Analysis</topic><topic>Analysis of Variance</topic><topic>Autoantibodies</topic><topic>Autoantibodies - metabolism</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Diabetes in children</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Diabetes Mellitus, Type 2 - immunology</topic><topic>Diagnosis</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Female</topic><topic>Fluorescent Antibody Technique, Indirect</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Islands of Langerhans</topic><topic>Islets of Langerhans</topic><topic>Islets of Langerhans - immunology</topic><topic>Juvenile diabetes</topic><topic>Male</topic><topic>Phenotype</topic><topic>Prospective Studies</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Perchard, R</creatorcontrib><creatorcontrib>MacDonald, D</creatorcontrib><creatorcontrib>Say, J</creatorcontrib><creatorcontrib>Pitts, J</creatorcontrib><creatorcontrib>Pye, S</creatorcontrib><creatorcontrib>Allgrove, J</creatorcontrib><creatorcontrib>Banerjee, K</creatorcontrib><creatorcontrib>Amin, R</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Perchard, R</au><au>MacDonald, D</au><au>Say, J</au><au>Pitts, J</au><au>Pye, S</au><au>Allgrove, J</au><au>Banerjee, K</au><au>Amin, R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>100</volume><issue>4</issue><spage>348</spage><epage>352</epage><pages>348-352</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><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.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>25409982</pmid><doi>10.1136/archdischild-2014-306542</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Analysis Analysis of Variance Autoantibodies Autoantibodies - metabolism Child Child, Preschool Children Diabetes in children Diabetes Mellitus, Type 2 - ethnology Diabetes Mellitus, Type 2 - immunology Diagnosis Enzyme-Linked Immunosorbent Assay Female Fluorescent Antibody Technique, Indirect Health aspects Humans Infant Infant, Newborn Islands of Langerhans Islets of Langerhans Islets of Langerhans - immunology Juvenile diabetes Male Phenotype Prospective Studies Risk factors |
| title | Islet autoantibody status in a multi-ethnic UK clinic cohort of children presenting with diabetes |
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