A1 Refereed original research article in a scientific journal
Extended family history of type 1 diabetes inHLA-predisposed children with and without islet autoantibodies
Authors: Salla Kuusela, Päivi Keskinen, Tytti Pokka, Mikael Knip, Jorma Ilonen, Paula Vähäsalo, Riitta Veijola
Publisher: WILEY
Publication year: 2020
Journal: Pediatric Diabetes
Journal name in source: PEDIATRIC DIABETES
Journal acronym: PEDIATR DIABETES
Volume: 21
Issue: 8
First page : 1447
Last page: 1456
Number of pages: 10
ISSN: 1399-543X
eISSN: 1399-5448
DOI: https://doi.org/10.1111/pedi.13122
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/50554515
Objective The aim of this study was to explore the extended family history of type 1 diabetes in children at genetic risk and define the impact of a positive family history on the development of islet autoimmunity and type 1 diabetes. Methods The subjects were participants in The Finnish Type 1 Diabetes Prediction and Prevention (DIPP) study and carried increased HLA-conferred risk for type 1 diabetes. The case children (N = 343) were positive for at least one islet autoantibody, and the control children (N = 343) matched by age, gender and class II HLA genotype were negative for islet autoantibodies at the time of data collection. Extended family history of type 1 diabetes was obtained by using a structured questionnaire. Results Among children who were autoantibody positive and progressed to type 1 diabetes 62.2% (28/45) had at least one relative with type 1 diabetes. Interestingly, 57.8% of these children (26/45) had such a relative outside the nuclear family compared to 30.7% of children with no autoantibodies (P= .001), 35.2% of those with only classical islet cell antibodies (P= .006), and 35.2% of non-progressors with biochemical autoantibodies (P= 0.011). A positive history of type 1 diabetes in the paternal extended family was more common in children with multiple biochemical autoantibodies compared to those with only one biochemical autoantibody (P= .010). No association between the specificity of the first appearing autoantibody and family history of the disease was found. Conclusions Type 1 diabetes in relatives outside the nuclear family is a significant risk factor for islet autoimmunity and progression to clinical disease in HLA susceptible children.
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