Authors: A J K Williams A J Norcross R J Dix K M Gillespie E A M Gale P J Bingley
Publish Date: 2003/09/09
Volume: 46, Issue: 10, Pages: 1354-1356
Abstract
The incidence of Type 1 diabetes shows little sex bias up to age 15 years but more males are diagnosed in early adult life Humoral responses to the beta cell antigen insulin could help to reveal the mechanism underlying this difference We therefore determined the influence of sex on the prevalence of insulin autoantibodies IAA at diagnosisOverall 74 of males and 65 of females had IAA above the 975th centile of 2860 schoolchildren p=0028 IAA prevalence was similar in males and females under the age of 15 0–4 yr 95 vs 88 5–9 yr 76 vs 73 10–14 yr 67 vs 58 but male excess was seen between 15 and 21 years 66 vs 32 p corr =0016 HLA class II genotype was available for 426 patients IAA prevalence in DR4 homozygous patients was 87 in DR4 heterozygous patients 72 and in DR4 negative patients 55 p0001 Multivariate analysis showed independent association of IAA with age p0001 number of DR4 alleles p0001 and male sex p=0002The prevalence of IAA in patients with newly diagnosed Type 1 diabetes is higher in males than females between 15 and 21 years of age The lower prevalence of IAA in adolescent females implies sexspecific modulation of the autoimmune process during pubertyThe pattern of onset of Type 1 diabetes differs between the sexes with earlier peak incidence in girls than boys and a higher incidence of disease in males than females after 15 years of age 1 The reason for this is unknown but differences in the prevalence of the various islet autoantibodies before and after diagnosis could provide indirect clues as to the mechanisms underlying this sex difference
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