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Genetics of Type 1A Diabetes
In their review article on the genetics
of type 1A diabetes, Concannon et al. (April
16 issue),1 citing Aly et al.,2 state that the disorder
develops in approximately 1 of 20 persons with
high-risk HLA haplotypes. Such data refer to siblings
of persons with type 1A diabetes. The real
challenge is to identify the development of type 1A
diabetes in the general population. A study involving
1031 healthy Sardinian schoolchildren (age
range, 10 to 16 years)3 showed that after a followup
period of 2.7 to 8.2 years, type 1A diabetes developed
in 1 of 8 children who were positive for
islet-related autoantibodies. Another study, involving
3000 schoolchildren,4 showed that type 1A diabetes
developed within 10 years in children with
two or more autoantibodies to distinct islet antigens,
with a positive predictive value of 50%. We
believe that only persons with islet autoantibodies
would benefit from genotyping when “true risk
variants for type 1 diabetes are fine mapped,
identified, and characterized.”
Multiple steps strategy for immunological prediction of type 1 diabetes in the general population
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The selection of control subjects for case/control analysis of susceptibility to type 1 (insulin-dependent) diabetes mellitus
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