On the appearance of islet associated autoimmunity in offspring of diabetic mothers: a prospective study from birth

Springer Science and Business Media LLC - Tập 36 - Trang 402-408 - 1993
A. -G. Ziegler1, B. Hillebrand1, W. Rabl2, M. Mayrhofer1, M. Hummel1, U. Mollenhauer1, J. Vordemann1, A. Lenz1, E. Standl1
1Diabetes Research Institute, Schwabing City Hospital, Munich, Germany
2Children's Hospital, Technical University, Munich, Germany

Tóm tắt

For the first time the incidence of insulin autoantibodies and islet cell antibodies were evaluated in a prospective study from birth. Consecutive neonates (168) from mothers with Type 1 (insulin-dependent) diabetes mellitus (n=113) and gestational diabetes (n=55) were included at birth. To date, follow-up sera were obtained from 90 of 168 mother-child-pairs 9 months postpartum and from 39 of 168, 2 years postpartum. At birth, there was a strong correlation between the presence of antibodies in the cord blood of neonates and in maternal circulation [Type 1 diabetic mothers: 20% islet cell antibodies ≥20 JDF-U (detection threshold of our islet cell antibody assay), 74% insulin antibodies >49 nU/ml (upper limit of normal range in sera of healthy control subjects aged 0.5 to 46 years); neonates: 21% islet cell antibodies ≥20 JDF-U, 76% insulin antibodies >49 nU/ml; gestational diabetic mothers: 11% islet cell antibodies ≥20 JDF-U, 18% insulin antibodies >49 nU/ml; neonates: 13% islet cell antibodies ≥20 JDF-U, 55% insulin antibodies >49 nU/ml]. This supports transplacental passage of insulin antibodies and islet cell antibodies from diabetic mothers to their offspring. During follow-up, the majority of children lost antibody-positivity after birth. A few offspring, however, exhibited or developed antibodies consistently, whereby insulin autoantibodies preceded islet cell antibodies in each case (antibody-positivity: 9 months: 0% islet cell antibody positive, 3.3% insulin autoantibody positive; 2 years: 2.6% islet cell antibody positive, 7.7% insulin autoantibody positive). Persisting antibody-positivity in follow-up samples of offspring of diabetic mothers was significantly correlated with older maternal age at delivery (median 38 vs 28 years, p<0.001). It is concluded that antibodies are common in cord blood of neonates of mothers with Type 1 and gestational diabetes, but they normally disappear after birth. In several children, however, islet cell autoimmunity is detected at very young age.

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Springer Science and Business Media LLC

Tập 36

402-408

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