Quantifying the utility of islet autoantibody levels in the prediction of type 1 diabetes in children
Authors' conclusion
Consideration of quantitative patterns of IAb levels improved the predictive power for type 1 diabetes in IAb-positive children beyond qualitative IAb positivity status.
Study context
- Population
- Children at increased genetic or familial risk of islet autoimmunity and diabetes who developed islet autoantibody (IAbs), prospective cohorts in Finland, Germany, Sweden and the USA523 developed diabetes
- Participants
- 1,403 children
- Comparison
- Prediction models with IAb levels vs positivity status vs baseline covariates
- Outcome
- Discriminative power for T1D (IPCW C index)
- Follow-up
- 10-year follow-up
Methodological detailsmultinational (Finland, Germany, Sweden, USA), multivariate logistic regression with inverse probability censored weighting (IPCW), 10-fold cross-validation, bootstrap 95% CI
- Multinational (Finland, Germany, Sweden, USA)
- Multivariate logistic regression with IPCW
- 10-fold cross-validation
- Bootstrap 95% CI
Performance
As reported in the abstract
C index for T1D prediction
Baseline model
0.61
C index · 95% CI 0.58–0.63
Baseline + IAb positivity
0.72
C index · 95% CI 0.71–0.74
Baseline + IAb levels
0.76
C index · 95% CI 0.74–0.77
IAb levels alone
0.76
C index · 95% CI 0.75–0.76
Further findings
C index by follow-up period
- C index at 2 years
- 0.82 (95% CI 0.81, 0.83)
- C index at 11 years
- 0.76 (95% CI 0.75, 0.76)
Adding a third IAb test (≈1.5 years after seroconversion) · 10 years follow-up
- C index
- 0.78 (95% CI 0.77, 0.78)
Original publication
Quantifying the utility of islet autoantibody levels in the prediction of type 1 diabetes in children. Diabetologia. Published 5 October 2022. doi:10.
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