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Refining the Defini...
Refining the Definition of Stage 1 Type 1 Diabetes : An Ontology-Driven Analysis of the Heterogeneity of Multiple Islet Autoimmunity
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- Frohnert, Brigitte I. (author)
- University of Colorado
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- Ghalwash, Mohamed (author)
- Ain Shams University,IBM Thomas J. Watson Research Center
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- Li, Ying (author)
- IBM Thomas J. Watson Research Center
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- Ng, Kenney (author)
- IBM Thomas J. Watson Research Center
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- Dunne, Jessica L. (author)
- Juvenile Diabetes Research Foundation
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- Lundgren, Markus (author)
- Lund University,Lunds universitet,Pediatrisk endokrinologi,Forskargrupper vid Lunds universitet,Paediatric Endocrinology,Lund University Research Groups,Central Hospital Kristianstad
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- Hagopian, William (author)
- Pacific Northwest Research Institute
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- Lou, Olivia (author)
- Juvenile Diabetes Research Foundation
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- Winkler, Christiane (author)
- Helmholtz Zentrum München
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- Toppari, Jorma (author)
- Turku University Hospital
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- Veijola, Riitta (author)
- University of Oulu
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- Anand, Vibha (author)
- IBM Thomas J. Watson Research Center
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(creator_code:org_t)
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- 2023-03-02
- 2023
- English 9 s.
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In: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 46:10, s. 1753-1761
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Abstract
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- OBJECTIVE To estimate the risk of progression to stage 3 type 1 diabetes based on varying definitions of multiple islet autoantibody positivity (mIA). RESEARCH DESIGN AND METHODS Type 1 Diabetes Intelligence (T1DI) is a combined prospective data set of children from Finland, Germany, Sweden, and the U.S. who have an increased genetic risk for type 1 diabetes. Analysis included 16,709 infants-toddlers enrolled by age 2.5 years and comparison between groups using Kaplan-Meier survival analysis. RESULTS Of 865 (5%) children with mIA, 537 (62%) progressed to type 1 diabetes. The 15-year cumulative incidence of diabetes varied from the most stringent definition (mIA/ Persistent/2: two or more islet autoantibodies positive at the same visit with two or more antibodies persistent at next visit; 88% [95% CI 85–92%]) to the least stringent (mIA/Any: positivity for two islet autoantibodies without co-occurring positivity or persistence; 18% [5–40%]). Progression in mIA/Persistent/2 was significantly higher than all other groups (P < 0.0001). Intermediate stringency definitions showed intermediate risk and were significantly different than mIA/Any (P < 0.05); however, differences waned over the 2-year follow-up among those who did not subsequently reach higher stringency. Among mIA/Persistent/2 individuals with three autoantibodies, loss of one autoantibody by the 2-year follow-up was associated with accelerated progression. Age was significantly associated with time from seroconversion to mIA/ Persistent/2 status and mIA to stage 3 type 1 diabetes. CONCLUSIONS The 15-year risk of progression to type 1 diabetes risk varies markedly from 18 to 88% based on the stringency of mIA definition. While initial categorization identifies highest-risk individuals, short-term follow-up over 2 years may help stratify evolving risk, especially for those with less stringent definitions of mIA.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
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- ref (subject category)
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- By the author/editor
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Frohnert, Brigit ...
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Ghalwash, Mohame ...
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Li, Ying
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Ng, Kenney
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Dunne, Jessica L ...
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Lundgren, Markus
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show more...
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Hagopian, Willia ...
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Lou, Olivia
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Winkler, Christi ...
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Toppari, Jorma
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Veijola, Riitta
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Anand, Vibha
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Endocrinology an ...
- Articles in the publication
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Diabetes Care
- By the university
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Lund University