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Novel Adipokines CTRP1, CTRP9, and FGF21 in Pediatric Type 1 and Type 2 Diabetes: A Cross-Sectional Analysis
Alexander Arking1,2,3, Dylan C Sarver2,3, Sheela N Magge1
1Department of Pediatric Endocrinology and Diabetes, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
Novel adipokines CTRP9 and FGF21 show distinct patterns in pediatric diabetes. CTRP9 is higher in type 1 diabetes (T1D), while FGF21 is higher in type 2 diabetes (T2D), impacting metabolic homeostasis.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pediatric Health
Background:
- Rising rates of pediatric obesity and diabetes (type 1 and type 2) necessitate understanding novel biomarkers.
- Limited knowledge exists on novel adipokines and hepatokines in pediatric diabetes populations.
Purpose of the Study:
- To investigate the levels of novel adipokines C1q/TNF-related proteins (CTRP1 and CTRP9) and hepatokine fibroblast growth factor 21 (FGF21) in children with type 1 diabetes (T1D) and type 2 diabetes (T2D).
- To assess the relationship between these novel adipokines and clinical characteristics in pediatric diabetes.
Main Methods:
- Cross-sectional analysis of 80 participants (40 T1D, 40 T2D) from the Pediatric Diabetes Consortium (PDC) registries.
- Comparison of CTRP1, CTRP9, and FGF21 levels between T1D and T2D cohorts.
- Regression models to evaluate associations between adipokines and clinical parameters like C-peptide and hemoglobin A1c.
Main Results:
- Participants with T2D had higher weight and BMI compared to T1D.
- CTRP9 levels were significantly higher in youth with T1D than T2D (p=0.04).
- FGF21 levels were significantly higher in youth with T2D than T1D (p=0.03).
- In T1D, CTRP9 correlated with C-peptide, and FGF21 with hemoglobin A1c.
- In T2D, CTRP1 correlated with hemoglobin A1c and glucose.
Conclusions:
- Distinct patterns of CTRP9 and FGF21 exist between pediatric T1D and T2D.
- These novel adipokines are associated with metabolic control in the inflammatory context of pediatric diabetes.
Introduction:
Pediatric obesity and diabetes has increased over the last several decades. While the role of common adipokines on metabolic parameters has been well studied in adults, the relationship of novel adipokines and hepatokines in pediatric type 1 (T1D) and type 2 diabetes (T2D) is not well understood. This study assessed novel adipokines C1q/TNF-related proteins (CTRP1 and CTRP9), and hepatokine fibroblast growth factor 21 (FGF21) in youth with T1D and T2D diabetes.
Methods:
Participants (n = 80) with T1D (n = 40) enrolled in the Pediatric Diabetes Consortium (PDC) T1D NeOn registry, and T2D (n = 40) from the PDC T2D registry. Cross-sectional analysis compared adipokines (CTRP1, CTRP9, FGF21) between T1D and T2D, and regression models assessed adipokine relationship with clinical characteristics.
Results:
The mean age of the participants was 14.9 ± 2 years, and 50% were female. T2D participants had a shorter diabetes duration (p = 0.0009), higher weight (p < 0.0001), and BMI (p < 0.0001) than T1D participants. CTRP9 levels were higher in T1D (13,903.6 vs. 3,608.5 pg/mL, p = 0.04) than T2D, and FGF21 levels were higher in T2D (113.1 vs. 70.6 pg/mL, p = 0.03) than T1D, with no differences in CTRP1. In regression analysis of T1D, CTRP9 was positively associated with C-peptide (p = 0.006), and FGF21 was positively associated with hemoglobin A1c (p = 0.04). In T2D, CTRP1 was positively associated with HbA1c (p < 0.001) and glucose (p = 0.004), even after controlling for age, sex, and BMI.
Conclusions:
CTRP9 levels are higher in youth with T1D compared to T2D, and FGF21 levels are higher in youth with T2D than T1D. Novel adipokines are related to metabolic homeostasis in the inflammatory milieu of pediatric diabetes.
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