Elsevier

Journal of Autoimmunity

Volume 7, Issue 6, December 1994, Pages 873-879
Journal of Autoimmunity

Regular Article
Do Glutamic Acid Decarboxylase Antibodies Improve the Prediction of IDDM in First-degree Relatives At Risk for IDDM?

https://doi.org/10.1006/jaut.1994.1071Get rights and content

Abstract

To determine whether the predictive value of islet cell antibodies (ICA) and insulin autoantibodies (IAA) is increased by measurement of glutamic acid decarboxylase antibodies (GADAb) in first-degree relatives of patients with insulin-dependent diabetes mellitus (IDDM), we measured GADAb in those developing IDDM and in relatives found to be ICA- or IAA-positive in our family screening study. First-degree relatives (n=2904) were followed for 2.4 (median, range 0.04-5.8) years. Of the subjects developing IDDM, 11/14 (78%) had ICA≥20JDF units, 1/14 (7%) had IAA≥100 nU/ml and 6/14 (43%) had GADAb (≥460nU/ml, measured by precipitation of enzymatic activity). Of the four subjects with ICA<20 and IAA<100 nU/ml who developed IDDM, one had elevated GADAb. Significant inhibition of GAD enzymatic activity by serum immunoglobulins, a potential cause of false-negative results in our immunoprecipitation assay, was not detected in seven subjects who developed IDDM in the absence of GADAb. Sixty-nine of the 2904 subjects with ICA≥20 or IAA>100 were followed for 3.1 (median range 0.1-5.4) years. Survival analysis showed that diabetes-free survival this group was not influenced significant by GADAb positivity. In conclusion, GADAb in the absence of ICA and IAA are uncommon in first-degree relatives who progress to IDDM and the presence of GADAb does not increase the risk for IDDM in ICA- or IAA-positive relatives.

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