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首页> 外文期刊>Diabetes care >Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes
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Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes

机译:相同且非本身的双胞胎:胰岛自身免疫发展的风险和因素和1型糖尿病

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摘要

OBJECTIVEThere are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings.RESEARCH DESIGN AND METHODSSubjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years.RESULTSAt screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects.CONCLUSIONSRisk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
机译:客观的是可变报告,有助于对胰岛自身抗体的进展的风险,并且在诊断一条双胞胎后,在相同的双胞胎中患1型糖尿病。我们检查了阳性自身抗体和1型糖尿病的发育以及遗传因子和常见环境对相同的双胞胎,非兄弟和完整兄弟姐妹的遗传因子阳性的影响。研究和方法从预防研究中的试验途径(n = 48,026)是从2004年到2015年筛选胰岛自身抗体(GAD抗体[GADA],胰岛素相关抗原2 [IA-2A]和胰岛素[IAA]的自身抗体。这些受试者,17,226(157个相同的双胞胎,283个非兄弟和16,786个完整的兄弟姐妹)进行自身抗体积极性或1型糖尿病,用于2.1年的中位数。筛查筛查,相同的双胞胎更有可能具有阳性的Gada,IA- 2A,和IAA而不是非本质双胞胎或完整的兄弟姐妹(所有P <0.0001)。年龄较小,男性性和遗传因素是表达Ia-2a,Iaa,Iaa,一种或多种阳性自身抗体和两种或更多种阳性自身抗体的重要因素(所有p 0.03)。最初自身抗体阳性相同的双胞胎在3年内患有69%的糖尿病风险,而最初是自身抗体阴性相同双胞胎的1.5%。在非Intidentical双胞胎中,初始自身抗体阳性的1型糖尿病风险为3年为72%,对于单一的自身抗体阳性,13%,初始自身抗体阴性非Intidentical Twins的0%。全兄弟姐妹的3年型1型糖尿病风险为47%,对于多种自身抗体阳性,12%的单一Autoalibody-阳性,最初的自身抗体阴性受试者为0.5%。最初为3年的1型糖尿病的结论为1型糖尿病多重和单一的自身抗体正相同等双胞胎和多重自身抗体正面的双胞胎。遗传倾向,年龄和男性性是双胞胎中阳性自身抗体的显着危险因素。

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