title: Relationship of body mass index and GAD65 antibody status on β-cell secretion at diabetes onset in African-American children.
abstract: Abstract Body mass and anti-pancreatic antibody status potentially influences the presentation of diabetes in children. We hypothesized that anti-pancreatic auto-antibody positive patients with new onset diabetes would have lower levels of insulin and C-peptide at presentation, and hence higher HbA1c. Records of children with new onset diabetes self-identified as African American were retrospectively analyzed. Patients were under 19 years of age. Anti-GAD65 antibody titer, HbA1c, blood glucose, insulin and C-peptide levels were drawn at the time of diagnosis. Patients were classified as antibody positive if anti-GAD65 was ≥ 0.5. HbA1c, insulin and C-peptide levels were considered as dependent variables in statistical models that included auto-antibody status, gender, age, body mass index z score (BMI-z score), and blood glucose as independent covariates. Records of 61 African-American children were available for analysis. There was no statistical association of auto-antibody status or initial clinical diagnosis with HbA1c, insulin or C-peptide level. BMI-z score was strongly associated with insulin (p=0.0006) and C-peptide (p<0.0001) levels. In general, higher BMI-z score, female gender and older age were associated with higher C-peptide levels. Although potentially helpful in eventually determining etiology, pancreatic auto-antibody levels do not have an association with HbA1c, insulin or C-peptide levels in African-American children with new onset diabetes. BMI-z score had the most robust association with insulin and C-peptide levels at presentation.
authors.forename: Pinar Gumus
authors.initials: PG
authors.lastname: Balikcioglu
authors.forename: Metin
authors.initials: M
authors.lastname: Balikcioglu
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gómez
authors.forename: Alfonso
authors.initials: A
authors.lastname: Vargas
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Chalew
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D044383:Black People; D015992:Body Mass Index; D002648:Child; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007515:Islets of Langerhans / Q000276:immunology* / Q000378:metabolism; D008297:Male; D014481:United States; D001741:Black or African American
chemical_list: D001323:Autoantibodies; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2