[Prediction of clinical remission using the C-peptide level in type 1 diabetes in children].
The aim of the study was to identify individual, clinical and metabolic factors that predict the C-peptide levels and appearance of clinical partial remission during the first year of type 1 diabetes (T1D) in children.


METHODS
197 type 1 diabetic patients (84 female and 113 male, mean age 10.4 years) were examined. C-peptide levels were detected by radioimmunoassay at the diagnosis and after 3, 6 and 12 months of the disease.


RESULTS
Median C-peptide level at onset was 0.17 pmol/mL (0.11-0.32), peaked in the 3rd month (0.27 pmol/mL, 0.15-0.43; p<0.001) and declined thereafter - 0.21 pmol/mL (0.1-0.34) in the 6th month and 0.13 pmol/mL (0.05-0.26) at the 12th month of the disease. Logistic regression showed that younger age, low pH and higher HbA1c (glycated haemoglobin) at the onset were associated with the "lower" (<0.28 pmol/mL) C-peptide level at the diagnosis. The presence of clinical partial remission was observed in 31% of children. Patients with remission had higher C-peptide levels observed in the first 6 months of T1D than children without clinical remission. Receiver operating characteristic (ROC) curve method was used for the estimation of the threshold of C-peptide level at the onset for the prediction of the clinical remission during the first year of T1D (0.141 pmol/mL, AUC (95%CI) = 0.608 (0.53-0.68)).


CONCLUSIONS
Concluding, higher C-peptide level is associated with the appearance of clinical partial remission during the first six months of T1D. C-peptide level may be a good predictor of the clinical partial remission during the first year of T1D.
Zmysłowska
Agnieszka
A
Clinic of Pediatrics, Medical University of Lodz, Poland/Klinika Chorób Dzieci l KP Uniwersytetu Medycznego w Łodzi. agazmysl@poczta.onet.pl
Młynarski
Wojciech
W
Szadkowska
Agnieszka
A
Bodalski
Jerzy
J
D000293:Adolescent; D017668:Age of Onset; D015415:Biomarkers / Q000097:blood; D002096:C-Peptide / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005215:Fasting / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D011863:Radioimmunoassay; D012075:Remission, Spontaneous; D013997:Time Factors
D015415:Biomarkers; D002096:C-Peptide; D006442:Glycated Hemoglobin