O-08: Autoantibody screening in First-Degree relatives of children with type 1 diabetes in a sibling-dominant cohort: a multicenter study on prevalence, determinants, and Post-Screening parent–child anxiety
U C Yilmaz, D Özalp Kızılay, Ö Kayır Kurt, İ B Balaban Berber, İ Gökdemir, A Ata, D Erden, E G Basa, Ö F Yalçın, S Onguner, H G Balki, S Kızılcan Çetin, S Özen, G Demir, G Yıldız Baş, M Soylu, A Anık, F Gürbüz, K Demir, Ö Köprülü, S A Altıncık, B Eroğlu Filibeli, B Özbaran, R Durusoy Onmuş, D GökşenAbstract
Introduction
We screened diabetes-associated autoantibodies in first-degree relatives (FDRs) of children aged 2–18 years with type 1 diabetes.
Objectives
To define prevalence and age distribution, identify determinants of autoantibody positivity, and quantify acute anxiety changes in children and parents following result disclosure.
Methods
In this multicenter cross-sectional study across nine pediatric endocrinology centers in Türkiye, 440 FDRs aged 2–18 years were screened. ZnT8, GAD, IAA, and IA-2 autoantibodies were measured by ELISA; perinatal variables were recorded. In the 8–18-year subsample, child anxiety was assessed by the Screen for Child Anxiety Related Emotional Disorders (SCARED) and parental anxiety by the State–Trait Anxiety Inventory (STAI-I/II), pre-screening and immediately after disclosure.
Results
Autoantibody positivity was 16.4%(72/440), and multiple autoantibodies were detected in 3.0%(13/440). Among 445 FDR relationships, 92.1% were sibling-based and 7.9% parent-based. ZnT8 was most common(11.4%) and predominated at ages 2–6 years(82% of positive children). ZnT8-positive children were younger than ZnT8-negative children(7.9±4.6 vs 10.0±4.5 years; p=0.002). Each additional week of gestational age was associated with lower odds of autoantibody positivity(aOR 0.80; p=0.005). SCARED increased after disclosure in positive children(d=1.3; p<0.001) but decreased in negative children(d=0.62; p<0.001). Parental anxiety increased after positive results(state d=2.19; trait d=0.69; p≤0.001) and decreased after negative results(p<0.001).
Conclusions
ZnT8 predominance in early childhood and the independent association of gestational age with autoantibody positivity support integrating age and perinatal history into presymptomatic risk stratification. The marked, outcome-dependent anxiety response indicates that screening programs should pair immunological testing with structured, result-specific counseling, integrating psychological support for parent–child anxiety responses with child-appropriate assessment.