Sabek Omaima M, Redondo Maria J, Nguyen Duc T, Beamish Christine A, Fraga Daniel W, Hampe Christiane S, Mulukutla Surya N, Graviss Edward A, Gaber A Osama
Department of Surgery The Methodist Hospital Houston TX USA.
Weill Cornell Medical College New York NY USA.
Endocrinol Diabetes Metab. 2019 Nov 29;3(1):e00104. doi: 10.1002/edm2.104. eCollection 2020 Jan.
We explored the association of C-peptide (marker of secreted insulin), proinsulin and proinsulin ⁄C-peptide ratio (PI/C) (markers of beta-cell endoplasmic reticulum [ER] stress) with undercarboxylated (uOC) and carboxylated osteocalcin (cOC) and their ratio (uOC/cOC) in children with recently diagnosed type 1 (T1D) or type 2 diabetes (T2D), and the correlation of these variables with partial remission (PR) in children with T1D.
Demographic and clinical data of children with new-onset diabetes (n = 68; median age = 12.2 years; 33.8% non-Hispanic White, 45.6% Hispanic/Latino, 16.2% African American and 4.4% other) were collected at diagnosis and during the first (V1), second (V2) and third clinical visits at 9.0, 32.0 and 175.7 weeks, respectively. Serum proinsulin, C-peptide, uOC and cOC values were measured 7.0 weeks after diagnosis. PR was defined as insulin dose-adjusted HbA1c (IDAA1c) ≤9.
In children with new-onset T1D with DKA (33.3%) or T2D (29.4%), Spearman's correlation coefficient revealed a positive association between the C-peptide levels and both uOC and uOC/cOC ratio. In T1D (n = 48), both higher serum C-peptide levels and low PI:C ratio were associated with higher BMI percentile ( = 0.02, = .001; = -0.01, = .02, respectively) and older age at diagnosis ( = 0.13, = .001; = -0.12, = .001, respectively). Furthermore, in children with T1D, C-peptide levels at V1 correlated with IDAA1c ≤ 9 at V1 ( = .04).
C-peptide levels are associated with a higher uOC and uOC/cOC ratio in paediatric diabetes. In new-onset T1D children, older age and higher BMI were associated with lower beta-cell stress and higher preserved function, which was predictive of PR on follow-up.
我们探讨了C肽（分泌型胰岛素的标志物）、胰岛素原以及胰岛素原/C肽比值（PI/C，β细胞内质网[ER]应激的标志物）与新诊断的1型（T1D）或2型糖尿病（T2D）患儿的羧化不全（uOC）和羧化骨钙素（cOC）及其比值（uOC/cOC）之间的关联，以及这些变量与T1D患儿部分缓解（PR）的相关性。
收集新发病糖尿病患儿（n = 68；中位年龄 = 12.2岁；33.8%非西班牙裔白人，45.6%西班牙裔/拉丁裔，16.2%非裔美国人和4.4%其他种族）诊断时以及分别在9.0、32.0和175.7周的首次（V1）、第二次（V2）和第三次临床就诊时的人口统计学和临床数据。诊断后7.0周测量血清胰岛素原、C肽、uOC和cOC值。PR定义为胰岛素剂量调整后的糖化血红蛋白（IDAA1c）≤9。
在患有糖尿病酮症酸中毒（DKA）的新发病T1D患儿（占33.3%）或T2D患儿（占29.4%）中，Spearman相关系数显示C肽水平与uOC以及uOC/cOC比值之间呈正相关。在T1D患儿（n = 48）中，较高的血清C肽水平和较低的PI:C比值均与较高的BMI百分位数相关（分别为r = 0.02，P = 0.001；r = -0.01，P = 0.02），且与诊断时年龄较大相关（分别为r = 0.13，P = 0.001；r = -0.12，P = 0.001）。此外，在T1D患儿中，V1时的C肽水平与V1时IDAA1c≤9相关（r = 0.04）。
在儿童糖尿病中，C肽水平与较高的uOC和uOC/cOC比值相关。在新发病的T1D患儿中，年龄较大和BMI较高与较低的β细胞应激和较高的保留功能相关，这可预测随访时的PR。
