Clinical evolution of beta cell function in youth with diabetes: the SEARCH for Diabetes in Youth study
| Autor: | Ralph B. D'Agostino, Catherine Pihoker, Jeanette S. Andrews, Dana Dabelea, Richard F. Hamman, G Imperatore, L. M. Dolan, Wilfred Y. Fujimoto, Barbara Linder, Elizabeth J. Mayer-Davis, Santica M. Marcovina, Carla J. Greenbaum |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Gerontology medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism Type 2 diabetes Article Body Mass Index Insulin resistance Predictive Value of Tests Risk Factors Insulin-Secreting Cells Diabetes mellitus Epidemiology Internal Medicine medicine Humans Age of Onset Child Autoantibodies Glycated Hemoglobin Type 1 diabetes C-Peptide business.industry Fasting medicine.disease United States Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Immunology Disease Progression Female Insulin Resistance Age of onset Beta cell business Body mass index Biomarkers |
| Zdroj: | Diabetologia. 55:3359-3368 |
| ISSN: | 1432-0428 0012-186X |
| Popis: | Few studies have explored the epidemiology of beta cell loss in youth with diabetes. This report describes the evolution and major determinants of beta cell function, assessed by fasting C-peptide (FCP), in the SEARCH for Diabetes in Youth study.Participants were 1,277 youth with diabetes (948 positive for diabetes autoantibodies [DAs] and 329 negative for DAs), diagnosed when aged20 years, who were followed from a median of 8 months post diagnosis, for approximately 30 months. We modelled the relationship between rate of change in log FCP and determinants of interest using repeated measures general linear models.Among DA-positive youth, there was a progressive decline in beta cell function of 4% per month, independent of demographics (age, sex, race/ethnicity), genetic susceptibility to autoimmunity (HLA risk), HbA(1c) and BMI z score, or presence of insulin resistance. Among DA-negative youth, there was marked heterogeneity in beta cell loss, reflecting an aetiologically mixed group. This group likely includes youths with undetected autoimmunity (whose decline is similar to that of DA-positive youth) and youth with non-autoimmune, insulin-resistant diabetes, with limited decline (~0.7% per month).SEARCH provides unique estimates of beta cell function decline in a large sample of youth with diabetes, indicating that autoimmunity is the major contributor. These data contribute to a better understanding of clinical evolution of beta cell function in youth with diabetes, provide strong support for the aetiological classification of diabetes type and may inform tertiary prevention efforts targeted at high-risk groups. |
| Databáze: | OpenAIRE |
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