Αναζήτηση ατόμων με προδιάθεση για σακχαρώδη διαβήτη τύπου 1 με προσδιορισμό ειδικών αυτοαντισωμάτων
Καραμήτσος, Δημήτριος - Σπυρίδων - Έριχ
The prediction of type 1 diabetes mellitus is a very interesting field of research because there are seve- ral intervention trials in process for the prevention of the disease. Markers used for the prediction of type 1 diabetes are the HLA genotype, the autoantibodies against antigens of ‚-cells (ICA, GAD65Ab, IAA, IA- 2Ab) and the lack of first phase insulin response in intravenous glucose tolerance test. The first degree relatives of type 1 diabetic patients are at increased risk of type 1 diabetes compared to general population. Aim. The identification of susceptible individuals to type 1 diabetes among the first degree relatives of patients with the disease using combination of autoantibodies (GAD65Ab, IA-2Ab and IAA) and their follow up. This study is concerning relatives of type 1 diabetic patients, who are inhabitants of Northern and Central Greece. Subjects-Methods. We examined 464 first degree relatives of patients with type 1 diabetes, aged 4-46 years, residents of Northern and Central Greece. GAD65Ab and IA-2Ab were determined simultaneously by RIA immunoprecipitation. IAA were measured by competitive RIA. The relatives with at least one antibody positive were retested for GAD65Ab, IA-2Ab and IAA after 6 months and had a glucose tolerance test per os. Results. Forty two relatives (9,05%) were positive at least to one of the antibodies measured (GAD65Ab, IA-2, IAA). Five of them (12%) developed diabetes or glucose intolerance during the follow-up period, which lasted 28+11 months. All of them were adults. None of the antibody negative relatives developed clinical symptoms of diabetes during follow-up. Twenty two of the relatives (4,74%) were positive to two or three antibodies. Positive to only one antibody were 20 relatives (4,31%). Conclusions. Among the residents of Northern and Central Greece there is a significant incidence of first degree relatives with type 1 diabetes, which are positive to autoantibodies against antigens of ‚-cells. The detection of GAD65Ab, IA-2Ab and IAA is recommended for the prediction of type 1 diabetes mellitus.
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