A1 Refereed original research article in a scientific journal
Factors Associated with Decline of C-peptide in a Cohort of Young Children Diagnosed with Type 1 Diabetes
Authors: Steck Andrea K, Liu Xiang, Krischer Jeffrey P, Haller Michael J, Veijola Riitta, Lundgren Markus, Ahmed Simi, Akolkar Beena, Toppari Jorma, Hagopian William A, Rewers Marian J, Elding Larsson Helena
Publisher: Oxford University Press
Publication year: 2021
Journal: Journal of Clinical Endocrinology and Metabolism
Volume: 106
Issue: 3
First page : e1380
Last page: e1388
eISSN: 1945-7197
DOI: https://doi.org/10.1210/clinem/dgaa715
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/51845588
Context: Understanding factors involved in the rate of C-peptide decline is needed to tailor therapies for type 1 diabetes (T1D).
Objective: Evaluate factors associated with rate of C-peptide decline after T1D diagnosis in young children.
Design: Observational study.
Setting: Academic centers.
Participants: 57 participants in The Environmental Determinants of Diabetes in the Young (TEDDY) enrolled at 3 months of age and followed until T1D and 56 age-matched children diagnosed with T1D in the community.
Intervention: A mixed meal tolerance test was used to measure the area under the curve (AUC) C-peptide at 1, 3, 6, 12 and 24 months post-diagnosis.
Outcome: Factors associated with rate of C-peptide decline during the first 2 years post-diagnosis were evaluated using mixed effects models adjusting for age at diagnosis and baseline C-peptide.
Results: Adjusted slopes of AUC C-peptide decline did not differ between TEDDY subjects and community controls (p=0.21), although the former had higher C-peptide baseline levels. In univariate analyses combining both groups (n=113), younger age, higher weight and BMI z-scores, female sex, increased number of islet autoantibodies, and IA-2A or ZnT8A positivity at baseline were associated with higher rate of C-peptide loss. Younger age, female sex and higher weight z-score remained significant in multivariate analysis (all p<0.02). At three months after diagnosis, higher HbA1c became an additional independent factor associated with higher rate of C-peptide decline (p<0.01).
Conclusion: Younger age at diagnosis, female sex, higher weight z-score, and HbA1c were associated with higher rate of C-peptide decline after T1D diagnosis in young children.
Downloadable publication This is an electronic reprint of the original article. |