Factors predicting course of beta-cell function in IDDM.
OBJECTIVE
The purpose of this study was to determine whether the severity o clinical presentation, sex, age, HLA type, and the presence of IAs and ICAs could predict the variation of residual insulin secretion as measured by the serum C-peptide response to a Sustacal meal.


METHODS
A cohort of 151 newly diagnosed IDDM children (mean age 10.2 +/- 4.6 yr) was followed prospectively for 3 yr. Thirty-five patients (12 males, 23 females) were still secreting C-peptide after 36 mo.


RESULTS
We found that age (P = 0.0001), sex (P = 0.003), presence of ICA (P = 0.006), severity of clinical presentation (P = 0.001), and symptom duration (P = 0.002) significantly predicted the rate of loss of C-peptide secretion. The risks of accelerated C-peptide disappearance decreased with increasing age, the risk ratios being 0.25 for the older group (greater than 12 yr) compared with the younger group (less than 6 yr) and 0.50 for the intermediate group (6-12 yr) compared with the younger group. The risk for the presence of ICA was 1.7, and the risk for males was 1.7 also. There was a significant negative correlation between ICA titers and C-peptide at 18 and 24 mo after diagnosis (P = 0.04). There were no significant differences in HbA1 values between patients who secreted C-peptide and those who did not.


CONCLUSIONS
We conclude that younger age of onset, male sex, high titers of ICA, severe clinical presentation, and shorter symptom duration significantly predict accelerated rates of loss of C-peptide secretion.
Schiffrin
A
A
Division of Endocrinology and Metabolism, Montreal Children's Hospital, Quebec, Canada.
Suissa
S
S
Weitzner
G
G
Poussier
P
P
Lalla
D
D
D000367:Age Factors; D001323:Autoantibodies / Q000032:analysis; D002096:C-Peptide / Q000097:blood / Q000378:metabolism*; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006680:HLA Antigens / Q000032:analysis; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012727:Sex Characteristics; D013997:Time Factors
D001323:Autoantibodies; D002096:C-Peptide; D006442:Glycated Hemoglobin; D006680:HLA Antigens; C024211:islet cell antibody