Islet cell antibodies (ICA) identify autoimmunity in children with new onset diabetes mellitus negative for other islet cell antibodies: Solitary islet cell antibody positivity
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AIMS: The aim of this study was to explore whether islet cell antibodies (ICA) could be identified in children with newly onset diabetes mellitus but negative for autoantibodies against glutamic acid decarboxylase (GADA), islet antigen-2 (IA-2A), insulin (IAA), or any of the three variants with arginine (R), tryptophan (W), or glutamine (Q) at position 325 of the zinc transporter 8 (ZnT8A). METHODS: A population-based analysis of autoantibodies was performed from 1 May 2005 to 2 September 2010 in Swedish children newly diagnosed with diabetes. ICA was analyzed with an enzyme-linked immunosorbent assay and if positive, reanalyzed in the classical ICA immunofluorescence assay, in 341 samples among 3545 children who had been tested negative for all of GADA, IA-2A, IAA, or ZnT8A (R, W, Q). RESULTS: An isolated positivity for ICA was identified in 5.0% (17/341) of the newly diagnosed children. The levels of ICA in positive subjects ranged from 3 to 183 JDF-U (median 30). This finding increased the diagnostic sensitivity of islet autoimmunity as 3204/3545 patients (90.4%) were islet autoantibody positive without the ICA analyses and 3221 patients (90.9%) were positive with the inclusion of ICA. CONCLUSIONS: The finding of an isolated positivity for ICA despite negativity for GADA, IA-2A, IAA, and ZnT8A (R, W, Q) suggests that still another yet unidentified autoantigen(s) may contribute to the ICA immunofluorescence. Hence, ICA is important to analyze in type 1 diabetes children and adolescents that would otherwise be islet autoantibody negative.
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Approximately 10% of individuals presenting with new-onset diabetes express only a single autoantibody.
“approximately 10% of individuals presenting with new-onset diabetes express only a single autoantibody (445).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [445]
The Results section ('ICA positivity in children enrolled in the Better Diabetes Diagnosis Study'; page unavailable) reports a single autoantibody—ICA—in 17 of 229 children with type 1 diabetes who had tested negative for the other autoantibodies, or about 7%. That is a selected subgroup, not approximately 10% of all individuals presenting with new-onset diabetes; the paper does not give the claimed overall prevalence of exactly one autoantibody. (LLM, conf=0.86)
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- Authors
- Andersson, C., Kolmodin, M., Ivarsson, S.-A., Carlsson, A., Forsander, G., Lindblad, B., Ludvigsson, J., Kockum, I., Marcus, C., Samuelsson, U., Örtqvist, E., Lernmark, Å., Elding Larsson, H., Törn, C., & on behalf of the Better Diabetes Diagnosis Study Group
- Affiliations
- Lund University (SE)
- Drottning Silvias barn- och ungdomssjukhus (SE)
- University of Gothenburg (SE)
- Linköping University (SE)
- Karolinska Institutet (SE)
- Linköping University Hospital (SE)
- Department of Clinical Sciences; Lund University; Malmö Sweden
- Corresponding author
- Törn, Carina
- ORCID
- Venue
- Pediatric Diabetes
- Publisher
- Wiley
- Published
- 2013-11-10
- Volume
- 15
- Issue
- 5
- Pages
- 336-344
- ISSN
- 1399-543X (ISSN-L)
- OpenAlex
- W1945765931
- Semantic Scholar
- 8e13c65e30bbc05499f08984640b274db0cd7188
- Cited by
- 44
- References
- 52
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 5 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 3 · 2014: 5
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- National Institute for Health Research (DK63861)
- Knut and Alice Wallenberg Foundation
- Lion Club International District 101-S
- Sk�ne County Council Foundation for Research and Development
- The Swedish Child Diabetes Foundation
- The Swedish Diabetes Association Research Fund
- The Swedish Research Council
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- islet cell antibodies, type 1 diabetes, pediatric diabetes, islet autoimmunity, glutamic acid decarboxylase antibodies, insulin autoantibodies, zinc transporter 8 antibodies, autoantigens, diagnostic sensitivity
- MeSH terms
- Adolescent, Autoantibodies, Autoantigens, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Glutamate Decarboxylase, Humans, Infant, Insulin, Islets of Langerhans, Male, Sweden, Autoimmunity
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