title: Variation of C peptide decay rate in diabetic patients with positive glutamic acid decarboxylase antibody: better discrimination with initial fasting C peptide.
abstract: BACKGROUND
  Diabetic patients with positive glutamic acid decarboxylase antibody (GAD-Ab) could be classified as autoimmune diabetes, which is discriminated into acute-onset classical type 1 diabetes (T1DM) and latent autoimmune diabetes in adults (LADA). However, whether the decay rate of beta cell function is relevant with the mode of onset (acute or latent-onset) is unclear. We aimed to investigate whether initial C peptide levels could help differentiate variation of C peptide decay rate.
  
  
  METHODS
  Five hundred and twenty-seven newly diagnosed GAD-Ab positive diabetic patients were followed up to assess the natural course of beta cell function. Beta cell function failure was defined as fasting C peptide and postprandial C peptide levels less than 100 pmol/L and 150 pmol/L respectively.
  
  
  RESULTS
  All these diabetic patients were discriminated according to initial fasting C peptide of 300 pmol/L, that is B+ (larger than 300 pmol/L) and B- (less than 300 pmol/L) group. The proportion of developing beta cell function failure was 13.1% in B+ group and 90.5% in B- group, which suggested that fasting C peptide levels made a good distinction of the heterogeneity in autoimmune diabetes. Receiver operator characteristic (ROC) analysis suggested that the fasting C peptide level of 300 pmol/L was optimal for determining beta cell function failure with sensitivity of 90.5% and specificity of 86.9%.
  
  
  CONCLUSIONS
  Initial level of fasting C peptide is a good indicator for predicting beta cell function failure in GAD-Ab positive diabetic patients.
authors: Key Laboratory of Diabetes Immunology, Ministry of Education; Diabetes Center, Metabolic Syndrome Research Center, Institute of Metabolism and Endocrinology, 2nd Xiangya Hospital, Central South University, No,139 Middle Renmin Road, 410011, Changsha, Hunan, P,R, China. zhouzg@hotmail.com.
authors: Xia
authors: X
authors: Li
authors: Gan
authors: G
authors: Huang
authors: Jian
authors: J
authors: Lin
authors: Lin
authors: L
authors: Yang
authors: Zhiguang
authors: Z
authors: Zhou