Distribution of C-peptide and its determinants in North American children at risk for type 1 diabetes.
OBJECTIVE
To determine basal and stimulated C-peptide percentiles in North American children and adolescents at risk for type 1 diabetes (T1D) and to examine factors associated with this distribution in the Diabetes Prevention Trial-Type 1 (DPT-1).


METHODS
We included 582 subjects aged 4-18 years at randomization in the DPT-1 trials. A 2-h oral glucose tolerance test (OGTT) was performed at baseline and every 6 months during the 5-year follow-up period. The percentile values of C-peptide after baseline OGTT were estimated according to age, BMI Z score (BMIZ), and/or sex categories. Conditional quantile regression was used to examine the relationship between C-peptide percentiles and various independent variables.


RESULTS
The basal and stimulated C-peptide levels increased significantly as age and BMIZ increased (P < 0.05). Both age and BMIZ had a stronger impact on the upper quartile of C-peptide distributions than the lower quartile. Sex was only significantly associated with stimulated C-peptide. Higher stimulated C-peptide levels were generally observed in girls compared with boys at the same age and BMIZ (P < 0.05). HLA type and number of positive antibodies and antibody titers (islet cell antibody [ICA], insulin autoantibody, GAD65A, and ICA512A) were not significantly associated with C-peptide distribution after adjustment for age, BMIZ, and sex.


CONCLUSIONS
Age-, sex-, and BMIZ-specific C-peptide percentiles can be estimated for North American children and adolescents at risk for T1D. They can be used as an assessment tool that could impact the recommendations in T1D prevention trials.
Pediatrics Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL ping.xu@epi.usf.edu.
Ping
P
Xu
Pediatrics Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL.
Xiaoning
X
Qian
Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL.
Desmond A
DA
Schatz
Pediatrics Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL.
David
D
Cuthbertson
Pediatrics Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL.
Jeffrey P
JP
Krischer
D000293:Adolescent; D001323:Autoantibodies / Q000276:immunology*; D002096:C-Peptide / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D007330:Insulin Antibodies / Q000276:immunology*; D008297:Male; D009656:North America; D012306:Risk
D001323:Autoantibodies; D002096:C-Peptide; D007330:Insulin Antibodies; C024211:islet cell antibody