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Multiple factors affect the loss of measurable C-peptide over 6 years in newly diagnosed 15- to 35-year-old diabetic subjects

Author:
  • Richard A. Jensen
  • Lisa K. Gilliam
  • Carina Törn
  • Mona Landin-Olsson
  • F. Anders Karlsson
  • Jerry P. Palmer
  • Ingrid Kockum
  • Karin Akesson
  • Barbro Lernmark
  • Kristian Lynch
  • Norman Breslow
  • Åke Lernmark
Publishing year: 2007
Language: English
Pages: 205-213
Publication/Series: Journal of Diabetes and its Complications1992-01-01+01:00
Volume: 21
Issue: 4
Document type: Journal article
Publisher: Elsevier

Abstract english

Objective: The aim of this study is to identify risk factors for the loss of measurable plasma C-peptide in newly diagnosed 15- to 35-year-old diabetic subjects. Methods: This Swedish study included 778 subjects. C-peptide levels were obtained each year for 6 years after diagnosis. Loss of measurable C-peptide was defined as a level at or below the lower detection limit of the local assay (0.13 nmol/1). In addition to C-peptide, other baseline covariates included gender, age, body mass index, HLA genotype, and autoantibody levels. Results: Compared with autoantibody-negative subjects, autoantibody-positive subjects had lower median baseline C-peptide (0.27 vs. 0.50, P<.001), their levels declined over the study period, and the risk of losing measurable C-peptide was significantly higher when more than one autoantibody was present [odds ratio (OR), 4.0; 95% confidence interval (CI), 2.13-7.54]. Among autoantibody-positive individuals, the presence of GAD65Ab (OR, 1.8; 95% CI, 1.24-2.51) and islet cell antibodies (OR, 1.6; 95% CI, 1.19-2.18) conferred a higher risk for loss of measurable C-peptide.as did female gender (OR, 1.6; 95% CI, 1.17-2.11) and time after diagnosis (OR, 1.5 for each additional year postdiagnosis; 95% CI, 1.41-1.57). Higher baseline C-peptide levels were protective (OR, 0.5 for each additional log, nanomoles per liter; 95% CI, 0.36-0.58). Conclusions: This study identified autoantibody status, gender, and baseline C-peptide levels as factors that will be useful for predicting the disease course of 15- to 35-year-old diabetic individuals. (C) 2007 Elsevier Inc. All rights reserved.

Keywords

  • Endocrinology and Diabetes
  • autoantibodies
  • c-peptide
  • type 1 diabetes mellitus
  • type 2 diabetes mellitus

Other

Published
  • Diabetes and Celiac Unit
  • ISSN: 1873-460X
E-mail: ake [dot] lernmark [at] med [dot] lu [dot] se

Principal investigator

Diabetes and Celiac Unit

+46 40 39 19 01

+46 70 616 47 79

60:11:015

Jan Waldenströms gata 35, Malmö

33

Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00