Prediction of type 1 diabetes in Sardinian schoolchildren using islet cell autoantibodies: 10-year follow-up of the Sardinian schoolchildren type 1 diabetes prediction study

Fernanda Velluzzi, Gianni Secci, Vincenzo Sepe, Catherine Klersy, Marion Shattock, Richard Foxon, Marco Songini, Stefano Mariotti, Mattia Locatelli, Gian Franco Bottazzo, Andrea Loviselli

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims: Stable genetic background makes individuals from the Mediterranean island of Sardinia ideal to define the predictive power of islet-related autoantibodies (IRAs): glutamic acid decarboxylase antibodies (GADA), tyrosine phosphatase-like antibodies (IA-2A), islet cell antibodies (ICA) to identify T1DM progressors. The aims of the present study were: (1) determination of IRAs reference limits in healthy non-diabetic Sardinian schoolchildren (SSc). (2) Predictive power evaluation of IRAs as single or combined determination to identify islet to identify T1DM progressors. Methods: Between 1986 and 1994, 8448 SSc were tested for IRAs. All were followed up for 10 years. The predictive power of single or combination of IRAs was determined as hazard ratio (HR), sensitivity, specificity, area under the ROC curve, negative and positive predictive value (NPV, PPV). Results: All 43 progressors to T1DM, but three showed at least one autoantibody positivity. HR for any single-autoantibody positivity was 55.3 times greater when compared to SSc negative for all IRAs. Any single autoantibody performed at least 64.9 % sensitivity with PPV always lower than 16 %. The best performing combination was ICA, plus IA-2A (showing 52.6 % sensitivity, 99.8 % specificity, 0.76 area under the ROC curve, 51.3 % PPV and 99.8 % NPV. Conclusions: Determination of IRAs reference limits in healthy SSc by standard statistical methods is crucial to establish the power of IRAs as progression markers to T1DM. Our data offer a solid rationale for future testing of ICA and IA-2A as routine laboratory markers to identify individuals at high risk of T1DM in the general population.

Original languageEnglish
Pages (from-to)73-79
Number of pages7
JournalActa Diabetologica
Volume53
Issue number1
DOIs
Publication statusPublished - Feb 1 2016

Fingerprint

Type 1 Diabetes Mellitus
Islets of Langerhans
Autoantibodies
ROC Curve
Area Under Curve
Mediterranean Islands
Sensitivity and Specificity
Glutamate Decarboxylase
Antibodies
Phosphoric Monoester Hydrolases
Italy
Tyrosine
Biomarkers

Keywords

  • Anti-insula autoantibodies
  • Epidemiology of T1DM
  • Prediction of T1DM

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Prediction of type 1 diabetes in Sardinian schoolchildren using islet cell autoantibodies : 10-year follow-up of the Sardinian schoolchildren type 1 diabetes prediction study. / Velluzzi, Fernanda; Secci, Gianni; Sepe, Vincenzo; Klersy, Catherine; Shattock, Marion; Foxon, Richard; Songini, Marco; Mariotti, Stefano; Locatelli, Mattia; Bottazzo, Gian Franco; Loviselli, Andrea.

In: Acta Diabetologica, Vol. 53, No. 1, 01.02.2016, p. 73-79.

Research output: Contribution to journalArticle

Velluzzi, Fernanda ; Secci, Gianni ; Sepe, Vincenzo ; Klersy, Catherine ; Shattock, Marion ; Foxon, Richard ; Songini, Marco ; Mariotti, Stefano ; Locatelli, Mattia ; Bottazzo, Gian Franco ; Loviselli, Andrea. / Prediction of type 1 diabetes in Sardinian schoolchildren using islet cell autoantibodies : 10-year follow-up of the Sardinian schoolchildren type 1 diabetes prediction study. In: Acta Diabetologica. 2016 ; Vol. 53, No. 1. pp. 73-79.
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AU - Secci, Gianni

AU - Sepe, Vincenzo

AU - Klersy, Catherine

AU - Shattock, Marion

AU - Foxon, Richard

AU - Songini, Marco

AU - Mariotti, Stefano

AU - Locatelli, Mattia

AU - Bottazzo, Gian Franco

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