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Distribution of C-peptide and its determinants in North American children at risk for type 1 diabetes

Ping Xu1, Xiaoning Qian2, Desmond A Schatz3

  • 1Pediatrics Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL ping.xu@epi.usf.edu.

Diabetes Care
|April 25, 2014
PubMed

Insights

Age, BMI, and sex influence C-peptide levels in North American children at risk for type 1 diabetes (T1D). These factors are crucial for establishing C-peptide percentiles in T1D prevention trials.

Area of Science:

  • Endocrinology
  • Pediatrics
  • Immunology

Background:

  • Type 1 diabetes (T1D) risk assessment in children requires understanding normal C-peptide levels.
  • C-peptide, a marker of insulin production, varies with age, body mass index (BMI), and sex.

Purpose of the Study:

  • To establish normative basal and stimulated C-peptide percentiles for North American children and adolescents at risk for T1D.
  • To identify demographic and clinical factors influencing C-peptide distribution within the Diabetes Prevention Trial-Type 1 (DPT-1) cohort.

Main Methods:

  • Analysis of 582 participants (aged 4-18) from the DPT-1 trials.
  • Oral glucose tolerance tests (OGTT) conducted at baseline and every 6 months over 5 years.
  • Conditional quantile regression used to model C-peptide percentiles against age, BMI Z-score (BMIZ), and sex.

Main Results:

  • Basal and stimulated C-peptide levels significantly increased with age and BMIZ (P < 0.05).
  • Age and BMIZ showed a greater impact on upper C-peptide quartiles.
  • Girls exhibited higher stimulated C-peptide levels than boys at similar ages and BMIZ (P < 0.05).
  • HLA type and autoantibody profiles did not significantly affect C-peptide distribution after adjustments.

Conclusions:

  • Age-, sex-, and BMIZ-specific C-peptide percentiles can be reliably estimated for at-risk pediatric populations.
  • These established percentiles can serve as valuable assessment tools for T1D prevention trials.
Abstract

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