Highlights
The Environmental Determinants of Islet Autoimmunity (ENDIA) prospective cohort has provided critical insights into the natural history of Type 1 Diabetes (T1D) markers. Key highlights include: 1) Zinc transporter 8 autoantibodies (ZnT8A) appear as the first islet autoantibody in 32% of children who develop persistent autoimmunity. 2) Persistent single ZnT8A detected solely by ELISA, typically appearing after age 4, does not appear to confer an increased risk of progression to clinical T1D. 3) In contrast, ZnT8A that progress to multiple autoantibodies or clinical disease are usually detected at an earlier age and are identifiable across multiple assay formats. 4) Maternal transmission of islet autoantibodies during pregnancy or through cord blood does not correlate with the subsequent development of islet autoantibodies in the offspring.
