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C-peptide levels and the prevalence of islets autoantibodies in children with type 1 diabetes mellitus with different duration of the disease

https://doi.org/10.14341/DM12843

Abstract

BACKGROUND: Type 1 diabetes mellitus (T1DM) is characterized by the development of absolute insulin deficiency. In some patients residual insulin secretion may persist for a long time. C-peptide is a widely used to measure the pancreatic beta cells function, in clinical practice and in research studies.

AIMTo assess C-peptide levels and presence of islets autoantibodies (Ab) in children with different duration of T1DM and to identify factors associated with the preserved secretion.

MATERIALS AND METHODS: Single-center cross-sectional study including data from 703 cases of children with T1DM, examined in the Endocrinology Research Center in 2016-2020, who was underwent a study of C-peptide levels and was positive for one or more islets antibodies (ZnT8, IA-2, GAD, ICA, IAA). There were 3 groups of patients: 1st — T1DM duration < 1 year, 2nd — from 1 to 5 years, 3rd — > 5 years.

RESULTS: The median of the fasting C-peptide level in the 1st group was 0.6 ng/ml [0.27; 1.09]; in the 2nd group — 0.2 ng/ml [0.01; 0.8]; in the 3rd group — 0.01 ng/ml [0.01; 0.037]. The preserved secretion of C-peptide (> 0.6 ng/ml) was determined in 51.4% in the 1st group, in 31.4% — in the 2nd group and in 11.4% in the 3rd group. In patients with obesity during the first year from the T1DM diagnosis C-peptide levels above 1.1 ng/ml was determined significantly more often (65.2%), as well as at the period of 1 to 5 years of the disease (35.7%), compared with children with normal BMI (18.5% and 14.5%, respectively) or overweight (15.7% and 19%, respectively), p <0.01. A negative correlation was found between C-peptide levels and the duration of T1DM (r = -0.489, p = 0.000), the daily dose of insulin (r = -0.637, p = 0.000), a positive association was found with the age of diagnosis of T1DM (r = 0.547, p = 0.000). The frequency of the presence of one type of islets autoantibodies in all groups was 29.5%, 2 types — 33.6%, 3 and more types — 36.9%. The titer of IA-2, ZnT8 decreased with the disease duration (p <0.05 and p <0.01, respectively), while the titer of ICA increased (p <0.01). No associations between the types, number, antibodies titer and C-peptide levels, age of disease manifestation were found.

CONCLUSION: C-peptide levels in children with T1DM in groups with older age at diagnosis and with obesity is significantly higher for the first 5 years of the disease. The study have shown the titer of IA-2, ZnT8 is decreasing with the disease duration, in turn, the frequency of detection of ICA increases. No association between C-peptide levels and the type, number and titer of antibodies were found.

About the Authors

E. M. Romanenkova
Endocrinology Research Centre
Russian Federation

Elizaveta M. Romanenkova, MD

11 Dm. Ulyanova street, 117036 Moscow

Researcher ID: AAB-7186-2021;

eLibrary SPIN: 6190-0118



I. A. Eremina
Endocrinology Research Centre
Russian Federation

Irina A. Eremina, MD, PhD

Moscow

Researcher ID: S-3979-2016;

Scopus Author ID: 6701334405;

eLibrary SPIN: 9411-4710



E. V. Titovich
Endocrinology Research Centre
Russian Federation

Elena V. Titovich, MD, PhD

Moscow

Researcher ID: AAO-2567-2020;

Scopus Author ID: 6507024916;

eLibrary SPIN: 7994-0797



E. A. Sechko
Endocrinology Research Centre
Russian Federation

Elena A. Sechko, MD, PhD

Moscow

Researcher ID: S-4114-2016;

Scopus Author ID: 55880018700;

eLibrary SPIN: 4608-5650



L. V. Nikankina
Endocrinology Research Centre
Russian Federation

Larisa V. Nikankina, MD, PhD

Moscow

Researcher ID: S-4114-2016;

Scopus Author ID: 55880018700;

eLibrary SPIN: 4608-5650



V. A. Peterkova
Endocrinology Research Centre
Russian Federation

Valentina A. Peterkova, MD, PhD, Professor, Academician of Russian Academy of Sciences

Moscow

e-library SPIN: 4009-2463



O. B. Bezlepkina
Endocrinology Research Centre

Olga B. Bezlepkina, MD, PhD

Moscow

Researcher ID: B-6627-2017;

Scopus Author ID: 6507632848;

eLibrary SPIN: 3884-0945



D. N. Laptev
Endocrinology Research Centre

Dmitry N. Laptev, MD, PhD

Moscow

Researcher ID: O-1826-2013;

Scopus Author ID: 24341083800;

e-library SPIN: 2419-4019



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Supplementary files

1. Рисунок 1. Уровень гликированного гемоглобина у детей с сахарным диабетом 1 типа в зависимости от длительности заболевания и пола.
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2. Рисунок 2. Суточная доза инсулина (СДИ) у детей с сахарным диабетом 1 типа в зависимости от длительности заболевания и пола.
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3. Рисунок 3. Уровень С-пептида натощак у детей с сахарным диабетом 1 типа при разной длительности заболевания в зависимости от пола.
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Type Исследовательские инструменты
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4. Рисунок 5. Частота низкой (<0,2 нг/мл), остаточной (0,2–0,6 нг/мл), сохранной (0,6–1,1 нг/мл) и нормальной (>1,1 нг/мл) секреции С-пептида у детей с сахарным диабетом 1 типа при разной длительности заболевания в зависимости от наличия избыточного веса/ожирения. А — при длительности СД менее 1 года. Б — при длительности заболевания от 1 до 5 лет.
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5. Рисунок 4. Частота сохранной, остаточной и низкой секреции С-пептида у детей с сахарным диабетом 1 типа при разной длительности заболевания.
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6. Рисунок 6. Частота выявления 1 и более видов специфических панкреатических аутоантител у детей с сахарным диабетом 1 типа с положительным титром аутоантител.
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7. Рисунок 7. Частота выявления различных видов аутоантител у пациентов, серопозитивных только по одному виду аутоантител.
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Type Исследовательские инструменты
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8. Рисунок 8. Частота выявления 1 и более видов специфических панкреатических аутоантител у детей с сахарным диабетом 1 типа при разной длительности заболевания.
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Type Исследовательские инструменты
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9. Рисунок 9. Частота выявления разных видов аутоантител при разной длительности сахарного диабета 1 типа у детей.
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10. Рисунок 10. Распространенность панкреатических аутоантител у детей с разной длительностью СД1 в зависимости от возраста манифестации заболевания: А — аутоантитела к инсулину (IAA), Б — аутоантитела к тирозинфосфатазе (IA-2), В — аутоантитела к глутаматдекарбоксилазе (GAD), Г — аутоантитела к транспортеру цинка 8 (ZnT8), Д — аутоантитела к островковым клеткам (ICA).
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Review

For citations:


Romanenkova E.M., Eremina I.A., Titovich E.V., Sechko E.A., Nikankina L.V., Peterkova V.A., Bezlepkina O.B., Laptev D.N. C-peptide levels and the prevalence of islets autoantibodies in children with type 1 diabetes mellitus with different duration of the disease. Diabetes mellitus. 2022;25(2):155-165. (In Russ.) https://doi.org/10.14341/DM12843

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ISSN 2072-0351 (Print)
ISSN 2072-0378 (Online)