Relationship of body mass index and GAD65 antibody status on β-cell secretion at diabetes onset in African-American children
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Pinar Gumus Balikcioglu
Abstract
Body mass and anti-pancreatic antibody status potentially influences the presentation of diabetes in children. We hypothesized that anti-pancreatic auto-antibody positive patients with new onset diabetes would have lower levels of insulin and C-peptide at presentation, and hence higher HbA1c. Records of children with new onset diabetes self-identified as African American were retrospectively analyzed. Patients were under 19 years of age. Anti-GAD65 antibody titer, HbA1c, blood glucose, insulin and C-peptide levels were drawn at the time of diagnosis. Patients were classified as antibody positive if anti-GAD65 was ≥0.5. HbA1c, insulin and C-peptide levels were considered as dependent variables in statistical models that included auto-antibody status, gender, age, body mass index z score (BMI-z score), and blood glucose as independent covariates. Records of 61 African-American children were available for analysis. There was no statistical association of auto-antibody status or initial clinical diagnosis with HbA1c, insulin or C-peptide level. BMI-z score was strongly associated with insulin (p=0.0006) and C-peptide (p<0.0001) levels. In general, higher BMI-z score, female gender and older age were associated with higher C-peptide levels. Although potentially helpful in eventually determining etiology, pancreatic auto-antibody levels do not have an association with HbA1c, insulin or C-peptide levels in African-American children with new onset diabetes. BMI-z score had the most robust association with insulin and C-peptide levels at presentation.
Parts of this study were presented at “The Endocrine Society’s 93rd Annual Meeting”, Boston, USA, 4–7 June, 2011.
Conflict of interest statement:
The authors have no conflict of interest to declare.
References
1. Campagna A, Pettitt DJ, Engelgau MM, Burrows NR, Geiss LS, et al. Type 2 diabetes among North American children and adolescents: an epidemiological review and a public health perspective. J Pediatr 2000;136:664–72.10.1067/mpd.2000.105141Search in Google Scholar
2. Dabelca D, Pettitt DJ, Jones KL, Arslanian SA. Type 2 diabetes mellitus in minority children and adolescents: an emerging problem. Endocrinol Metab Clin North Am 1999;28: 709–29.10.1016/S0889-8529(05)70098-0Search in Google Scholar
3. The Writing Group for the SEARCH for Diabetes in Youth Study Group, Dabelea D, Bell RA, D’Agostino RB Jr, Imperatore G, et al. Incidence of diabetes in youth in the United States. J Am Med Assoc 2007;297:2716–24.10.1001/jama.297.24.2716Search in Google Scholar PubMed
4. Gumus P, Gómez R, Vargas A, Chalew S. The relationship of insulin secretion and GAD65 antibody levels at diagnosis on glycemic control in type 2 diabetes. J Clin Endocrinol Metab 2010;23:1025–9.10.1515/jpem.2010.163Search in Google Scholar PubMed
5. Libman IM, Pietropaola M, Arslanian SA, LaPorte RE, Becker DJ. Evidence for heterogenous pathogenesis of insulin treated diabetes in black and white children. Diabetes Care 2003;26:2876–82.10.2337/diacare.26.10.2876Search in Google Scholar PubMed
6. Wilkin TJ. The accelerator hypothesis: a review of the evidence for insulin resistance as the basis for type I as well as type II diabetes. Int J Obes (Lond) 2009;33:716–26.10.1038/ijo.2009.97Search in Google Scholar PubMed
7. Tfayli H, Bacha F, Gungor N, Arslanian S. Phenotypic type 2 diabetes in obese youth: insulin sensitivity and secretion in islet cell antibody-negative versus -positive patients. Diabetes 2009;58:738–44.10.2337/db08-1372Search in Google Scholar PubMed PubMed Central
8. Dabelea D, Pihoker C, Talton JW, D’Agostino RB Jr, Fujimoto W, et al. Etiological approach to characterization of diabetes type: the SEARCH for Diabetes in Youth study. Diabetes Care 2011;34:1628–33.10.2337/dc10-2324Search in Google Scholar PubMed PubMed Central
9. Dabelea D, D’Agostino RB Jr, Mason CC, West N, Hamman RF, et al. Development, validation and use of an insulin sensitivity score in youths with diabetes: the SEARCH for Diabetes in Youth study. Diabetologia 2011;54:78–86.10.1007/s00125-010-1911-9Search in Google Scholar PubMed PubMed Central
10. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2008;31(Suppl 1):S55–60.10.2337/dc08-S055Search in Google Scholar PubMed
©2013 by Walter de Gruyter Berlin Boston
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- Images in pediatric endocrinology
- Lingual thyroid
- Original articles
- A levothyroxine dose recommendation for the treatment of children and adolescents with autoimmune thyroiditis induced hypothyroidism
- Fasting glucagon-like peptide-1 in patients with overt hyperthyroidism and euthyroid congenital hypothyroidism
- Perinatal complications and higher risks of offspring thyroid dysfunction in early childhood of Graves’ disease mothers with euthyroidism
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- Lissencephaly presenting with congenital hypothyroidism
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