title: Urinary C-Peptide/Creatinine Ratio Can Distinguish Maturity-Onset Diabetes of the Young from Type 1 Diabetes in Children and Adolescents: A Single-Center Experience.
abstract: BACKGROUND
  The urinary C-peptide/creatinine ratio (UCPCR) and fasting C-peptide level can assess beta-cell function in clinical practice. In the present study, the use of the UCPCR and fasting C-peptide levels was investigated in the differential diagnosis between maturity-onset diabetes of the young (MODY) and type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  Twenty-seven patients with genetically confirmed MODY by next-generation sequence analysis and 42 children with T1DM were included. C-peptide levels were measured after an overnight fast before breakfast, and urine samples were collected 2 h after a standard lunch in the hospital.
  
  
  RESULTS
  The UCPCR in the T1DM group was 0.17 ± 0.5 nmol/mmol, and in the MODY group it was 1.27 ± 1.03 nmol/mmol (p = 0.001). The receiver operating characteristic (ROC) curves showed excellent discrimination (area under the curve 0.93). A UCPCR ≥0.22 nmol/mmol yielded a 96.3% sensitivity and an 85.7% specificity. The fasting C-peptide level in the T1DM group was lower than that in the MODY group (p = 0.001). The fasting C-peptide cutoff determined by ROC curve analysis was 0.62 ng/ml, with a sensitivity of 93% and a specificity of 90% for discriminating between MODY and T1DM.
  
  
  CONCLUSIONS
  We showed that the UCPCR and fasting C-peptide levels in children and adolescents can distinguish patients with MODY from patients with T1DM with high specificity and sensitivity. A value of UCPCR ≥0.22 nmol/mmol may indicate further genetic testing for MODY.
authors: Pediatric Endocrinology Clinic, Dr. Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey.
authors: Sebahat
authors: S
authors: Yılmaz Agladioglu
authors: Elif
authors: E
authors: Sagsak
authors: Zehra
authors: Z
authors: Aycan
mesh_terms: D000293:Adolescent; D002096:C-Peptide / Q000652:urine*; D002648:Child; D003404:Creatinine / Q000652:urine*; D003922:Diabetes Mellitus, Type 1 / Q000652:urine*; D003924:Diabetes Mellitus, Type 2 / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D002096:C-Peptide; D003404:Creatinine