title: Clinical presentation and autoimmune characteristics of very young children at the onset of type 1 diabetes mellitus.
abstract: The aim of our study was to identify factors that are related to a more aggressive beta-cell destruction in children at presentation of type 1 diabetes mellitus (T1D). We analyzed age, HbAlc, pH, bicarbonate, IAA, IA2, GADA, C peptide of 290 consecutive patients with T1D at onset. Seventy-three (25.2%) were younger than 4 years; 217 (74.8%) were aged 4-18 years. Younger patients had lower C peptide, pH and bicarbonate than older ones. Age at T1D onset was negatively related to IAA titers (r: -0.3404, p < 0.001), positively related to IA2 titers (r: 0.1249, p: 0.03) and to C peptide (r: 0.42, p: < 0.001). Multivariable linear regression showed that C peptide was negatively related to HbA1c and positively related to age, pH at admission and IAA titers. T1D in very young children is characterized by a more extensive beta-cell destruction, and younger age at onset is related to a more severe decompensation.
authors.affiliation: Unit of Endocrinology and Diabetes, Bambino Gesù Children's Hospital, University of Rome Tor Vergata, Piazza S. Onofrio, Rome, Italy. bizzarri@opbg.net
authors.forename: Carla
authors.initials: C
authors.lastname: Bizzarri
authors.forename: Danila
authors.initials: D
authors.lastname: Benevento
authors.forename: Paolo
authors.initials: P
authors.lastname: Ciampalini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Patera Ippolita
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiaffini
authors.forename: Antonella
authors.initials: A
authors.lastname: Migliaccio
authors.forename: Lucilla
authors.initials: L
authors.lastname: Ravà
authors.forename: Marco
authors.initials: M
authors.lastname: Cappa
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood*; D002096:C-Peptide / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007330:Insulin Antibodies / Q000097:blood; D050417:Insulin-Secreting Cells / Q000473:pathology; D016014:Linear Models; D008297:Male
chemical_list: D001323:Autoantibodies; D002096:C-Peptide; D005968:Glutamate Decarboxylase; D006442:Glycated Hemoglobin; D007330:Insulin Antibodies; C517652:hemoglobin A1c protein, human