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Seroconversion to multiple islet autoantibodies and progression

One-paragraph summary

Prospective childhood cohorts were pooled to quantify progression after islet-autoantibody seroconversion. Children with multiple autoantibodies had 69.7% (95% CI 65.1–74.3) risk of T1D within 10 years and 84% within 15 years; single-antibody risk was 14.5% at 10 years and risk with no antibodies was 0.4% by age 15 (PMID 23780460).

Key findings

  • Antibody multiplicity separates high-risk early disease from heterogeneous single positivity.
  • Younger seroconversion and high-risk HLA accelerated progression.
  • These data underpin the stage-1 definition.

Limitations

  • Genetically enriched childhood cohorts do not fully represent adult-onset or all ancestries.
  • Group risks do not predict an individual diagnosis date.

Why it matters

The paper converted autoantibody positivity from a vague risk marker into a quantitative disease-stage anchor.

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