Preservation of β-Cell Function in Autoantibody-Positive Youth With Diabetes
Preservation of β-Cell Function in Autoantibody-Positive Youth With Diabetes
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DOI：
10.2337/dc08-2326
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发表时间：
2009-10-01
期刊：
影响因子：
16.2
通讯作者：
Pihoker, Catherine
中科院分区：
文献类型：
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作者：
Greenbaum, Carla J.;Anderson, Andrea M.;Pihoker, Catherine
研究设计和方法-来自青年糖尿病研究中心的2，789名GAD 65和/或IA 2自身抗体阳性的1-23岁青年的空腹C肽水平。根据糖尿病控制和并发症试验（DCCT）（空腹C肽>= 0.23 ng/ml）和国家健康和营养调查（NHANES）美国青少年人群空腹C肽第5百分位数（>= 1.0 ng/ml）的临界点定义保留的β细胞功能。我们比较了有和没有保留β细胞function.Results的临床特征-在诊断的第一年内，82.9%的青年空腹C-肽>= 0.23 ng/ml，31.1%的值>= 1.0 ng/ml。在糖尿病病程5年的患者中，10.7%的人根据DCCT临界值保留了β细胞功能，1.0%的人高于NHANES人群的第5百分位数。五分之四的自身抗体阳性糖尿病青年有临床显著量的残余β细胞功能，约三分之一的空腹C-肽水平高于健康青少年人群的第5百分位数。即使在诊断后5年，1/1.0的患者空腹C肽高于临床显著阈值。这些发现对青年糖尿病患者的临床分类以及旨在保护糖尿病发作后β细胞功能的临床试验具有重要意义。
OBJECTIVE - To determine the extent of beta-cell function in youth with diabetes and GAD65 and/or IA2 autoantibodies.RESEARCH DESIGN AND METHODS - Fasting C-peptide levels from 2,789 GAD65- and/or IA2 autoantibody-positive youth aged 1-23 years from the SEARCH for Diabetes in Youth study were used. Preserved beta-cell function was defined on the basis of cut points derived from the Diabetes Control and Complications Trial (DCCT) (fasting C-peptide >= 0.23 ng/ml) and from the U.S. adolescent population of the National Health and Nutrition Examination Survey (NHANES) 5th percentile for fasting C-peptide (>= 1.0 ng/ml). We compared the clinical characteristics between those with and without preserved beta-cell function.RESULTS - Within the first year of diagnosis, 82.9% of youth had a fasting C-peptide >= 0.23 ng/ml and 31.1% had values >= 1.0 ng/ml. Among those with 5 years of diabetes duration, 10.7% had preserved beta-cell function based on the DCCT cutoff and 1.0% were above the 5th percentile of the NHANES population.CONCLUSIONS - Within the 1st year of diagnosis, four of five youth with autoantibody-positive diabetes have clinically significant amounts of residual beta-cell function and about one-third have fasting C-peptide levels above the 5th percentile of a healthy adolescent population. Even 5 years after diagnosis, 1 of 1.0 has fasting C-peptide above a clinically significant threshold. These findings have implications for clinical classification of youth with diabetes as well as clinical trials aimed to preserve beta-cell function after diabetes onset.