Odyjewska Emilia, Kupińska Monika, Jamiołkowska-Sztabkowska Milena, Bossowski Artur, Głowińska-Olszewska Barbara
Department of Pediatrics, Endocrinology, and Diabetology with Cardiology Division, Medical University of Bialystok, Białystok, Poland.
Front Endocrinol (Lausanne). 2025 Jun 18;16:1602777. doi: 10.3389/fendo.2025.1602777. eCollection 2025.
Maintaining endogenous insulin secretion in type 1 diabetes (T1D) long after its onset, and thus the need for early diagnosis and searching for factors preserving the secretory function of β-cells, has become an important goal of current research. The aim of the study was to evaluate C-peptide secretion in T1D children with at least 1 year disease duration and to investigate the potential role of body mass index (BMI) and betatrophin on residual β-cell function. We also assessed factors that may affect betatrophin levels.
121 children and adolescents suffering from T1D were divided into groups based on: clinical significance of C-peptide; BMI-SDS <1 and ≥1; and disease duration to compare C-peptide and betatrophin levels and determine the importance of these changes.
Of the children recruited, 44 (36.36%) had clinically significant C-peptide (> 0.23 ng/ml), and compared with the group with clinically insignificant C-peptide they had later onset (P<.001), shorter duration of illness (P<.001), lower daily insulin requirement (P=.025), lower mean HbA1c over the past year (P=.002), higher betatrophin levels (P=.019), and BMI-SDS at diagnosis (P=.013). Betatrophin levels correlated positively with C-peptide (P=.043) while negatively with patient's age (P<.001), BMI-SDS (P=.010), disease duration (P=.006), HbA1c level at sampling (P=.022), average HbA1c level over the past year (P=.006), and basal insulin (P=.001).
The positive significant relationship between betatrophin and C-peptide concentrations may indicate betatrophin as a potential biomarker of long-lasting residual β-cell function. Negative correlation with BMI identifies the ongoing need to maintain an appropriate body mass.
在1型糖尿病（T1D）发病很久之后维持内源性胰岛素分泌，因此早期诊断并寻找能保留β细胞分泌功能的因素，已成为当前研究的重要目标。本研究的目的是评估病程至少1年的T1D儿童的C肽分泌情况，并探讨体重指数（BMI）和β细胞营养因子对残余β细胞功能的潜在作用。我们还评估了可能影响β细胞营养因子水平的因素。
121名患有T1D的儿童和青少年根据以下因素分组：C肽的临床意义；BMI-SDS<1和≥1；以及病程，以比较C肽和β细胞营养因子水平，并确定这些变化的重要性。
在招募的儿童中，44名（36.36%）具有临床显著意义的C肽（>0.23 ng/ml），与C肽无临床意义的组相比，他们发病较晚（P<0.001）、病程较短（P<0.001）、每日胰岛素需求量较低（P=0.025）、过去一年的平均糖化血红蛋白较低（P=0.002）、β细胞营养因子水平较高（P=0.019）以及诊断时的BMI-SDS较高（P=0.013）。β细胞营养因子水平与C肽呈正相关（P=0.043），而与患者年龄呈负相关（P<0.001）、与BMI-SDS呈负相关（P=0.010）、与病程呈负相关（P=0.006）、与采样时的糖化血红蛋白水平呈负相关（P=0.022）、与过去一年的平均糖化血红蛋白水平呈负相关（P=0.006）以及与基础胰岛素呈负相关（P=0.001）。
β细胞营养因子与C肽浓度之间的显著正相关可能表明β细胞营养因子是长期残余β细胞功能的潜在生物标志物。与BMI的负相关表明持续需要维持适当的体重。
