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Factors Associated with Decline of C-peptide in a Cohort of Young Children Diagnosed with Type 1 Diabetes

Steck Andrea K; Rewers Marian J; Akolkar Beena; Hagopian William A; Toppari Jorma; Krischer Jeffrey P; Liu Xiang; Lundgren Markus; Haller Michael J; Ahmed Simi; Elding Larsson Helena; Veijola Riitta

Factors Associated with Decline of C-peptide in a Cohort of Young Children Diagnosed with Type 1 Diabetes

Steck Andrea K
Rewers Marian J
Akolkar Beena
Hagopian William A
Toppari Jorma
Krischer Jeffrey P
Liu Xiang
Lundgren Markus
Haller Michael J
Ahmed Simi
Elding Larsson Helena
Veijola Riitta
Katso/Avaa
Final draft (1005.Kb)
Lataukset: 

Oxford University Press
doi:10.1210/clinem/dgaa715
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021042823699
Tiivistelmä

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.

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