Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy.
Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, 98124 Messina, Italy.
Int J Environ Res Public Health. 2020 Jul 3;17(13):4801. doi: 10.3390/ijerph17134801.
Partial clinical remission (PCR) is a transitory period characterized by the residual endogenous insulin secretion following type 1 diabetes (T1D) diagnosis and introducing the insulin therapy. Scientific interest in PCR has been recently increasing, as this phase could be crucial to preserve functional beta cells after T1D onset, also taking advantage of new therapeutic opportunities. The aim of this study was to assess the frequency, duration and associated factors of PCR in children newly diagnosed with T1D. Our cohort study included 167 pediatric patients aged 13.8 ± 4.1 years. The association of clinical and laboratory factors with the occurrence and duration of PCR was evaluated via logistic regression and multivariable generalized linear model, respectively. PCR occurred in 63.5% of the examined patients. Patients who achieved the remission phase were significantly older, and they had lower daily insulin requirement compared with non-remitters. PCR was positively associated to body mass index (OR = 1.11; = 0.032), pH value (OR 49.02; = 0.003) and c-peptide levels (OR 12.8; = 0.002). The average duration of PCR was 13.4 months, and older age at diagnosis was the only predictor factor. Two years after diagnosis remitter patients had lower HbA1c and daily insulin requirement.
部分临床缓解（PCR）是 1 型糖尿病（T1D）诊断后和引入胰岛素治疗时残留内源性胰岛素分泌的短暂阶段。PCR 阶段对于 T1D 发病后保留功能性β细胞非常重要，同时也可以利用新的治疗机会，因此，最近科学界对 PCR 的兴趣有所增加。本研究旨在评估新诊断为 T1D 的儿童中 PCR 的频率、持续时间和相关因素。我们的队列研究纳入了 167 名年龄为 13.8 ± 4.1 岁的儿科患者。通过逻辑回归和多变量广义线性模型分别评估临床和实验室因素与 PCR 的发生和持续时间的相关性。在检查的患者中，63.5%发生了 PCR。达到缓解阶段的患者明显年龄较大，与未缓解者相比，他们的每日胰岛素需求较低。PCR 与体重指数（OR = 1.11； = 0.032）、pH 值（OR 49.02； = 0.003）和 C 肽水平（OR 12.8； = 0.002）呈正相关。PCR 的平均持续时间为 13.4 个月，诊断时年龄较大是唯一的预测因素。诊断后 2 年，缓解患者的 HbA1c 和每日胰岛素需求较低。
