Surrogate markers and predictors of endogenous insulin secretion in children and adolescents with type 1 diabetes
作者机构：Department of EndocrinologyNational Clinical Research Center for Child HealthThe Children's HospitalZhejiang University School of MedicineHangzhou 310003China Department of PediatricsShaoxing Women and Children's HospitalShaoxingChina Liggins InstituteUniversity of AucklandAucklandNew Zealand A Better Start-National Science ChallengeUniversity of AucklandAucklandNew Zealand Department of Women’s and Children’s HealthUppsala UniversityUppsalaSweden
出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)
年 卷 期：2021年第17卷第1期
页 面：99-105页
核心收录：
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100202[医学-儿科学] 10[医学]
基 金：supported by National Key Research and Development Program of China(No.2016YFC1305301) National Natural Science Foundation of China(No.81570759) Research Fund of Zhejiang Major Medical and Health Science and Technology and National Ministry of Health(WKJ-ZJ-1804) supported by a travel fellowship from the New Zealand-China Non-Communicable Diseases Research Collaboration Center
主 题：Endogenous insulin secretion Mixed-meal tolerance test(MMTT) Type 1 diabetes mellitus
摘 要：Background No studies have examined endogenous insulin secretion in pediatric patients with type 1 diabetes in China using the gold-standard mixed-meal tolerance *** the latter is labor-intensive,we examined simpler surrogate markers of endogenous insulin secretion in Chinese youth,as previously reported for a European *** Participants were 57 children and adolescents with type 1 diabetes aged 4.4-16.8 years(56% females).We per-formed 120-minute mixed-meal tolerance tests with serum C-peptide(CP)measurements every 30 *** insulin deficiency(SID)was defined as CP peak0.2 nmol/*** CP and creatinine levels were measured at 0 and 120 *** Twenty-five(44%)patients had *** CP levels missed one case(96% sensitivity)with no false posi-tives(100% specificity).While the 120-minute urine CP/creatinine had 100% sensitivity,it yielded markedly lower speci-ficity(63%).Every 1-year increase in diabetes duration and 1-year decrease in age at diagnosis were associated with 37%(P0.001)and 20%(P=0.005)reductions in serum CP area-under-the-curve,***,86% of children aged5 years had SID compared to none among patients aged ≥11 *** Simple fasting CP measurements could be used to detect most SID cases in Chinese youth with type 1 *** CP is a far more reliable measure of endogenous insulin secretion than the more commonly used insulin ***,it could more precisely determine insulin secretory capacity to target those who could benefit,if treatments to preserve residual insulin secretion are developed.
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