title: Serum Trypsinogen Levels in Type 1 Diabetes.
abstract: The pancreas in type 1 diabetes exhibits decreased size (weight/volume) and abnormal exocrine morphology. Serum trypsinogen levels are an established marker of pancreatic exocrine function. As such, we hypothesized that trypsinogen levels may be reduced in patients with pre-type 1 diabetes and type 1 diabetes compared with healthy control subjects.
  
  
  
  Serum trypsinogen levels were determined in 100 persons with type 1 diabetes (72 new-onset, 28 established), 99 autoantibody-positive (AAb+) subjects at varying levels of risk for developing this disease, 87 AAb-negative (AAb-) control subjects, 91 AAb-relatives with type 1 diabetes, and 18 patients with type 2 diabetes.
  
  
  
  Trypsinogen levels increased significantly with age in control subjects (r= 0.71;P< 0.0001) and were significantly lower in patients with new-onset (mean ± SD 14.5 ± 6.1 ng/mL;P< 0.0001) and established type 1 diabetes (16.7 ± 6.9 ng/mL;P< 0.05) versus AAb-control subjects (25.3 ± 11.2 ng/mL), AAb-relatives (29.3 ± 15.0 ng/mL), AAb+subjects (26.5 ± 12.1 ng/mL), and patients with type 2 diabetes (31.5 ± 17.3 ng/mL). Multivariate analysis revealed reduced trypsinogen in multiple-AAb+subjects (P< 0.05) and patients with type 1 diabetes (P< 0.0001) compared with AAb-subjects (control subjects and relatives combined) and single-AAb+(P< 0.01) subjects when considering age and BMI.
  
  
  
  These findings further support the interplay between pancreatic endocrine and exocrine dysfunction. Longitudinal studies are warranted to validate trypsinogen as a predictive biomarker of type 1 diabetes progression.
authors.affiliation: Institute of Metabolism and Endocrinology, The Second Xiangya Hospital and the Diabetes Center, Metabolic Syndrome Research Center, Central South University, National Clinical Research Center for Metabolic Diseases, Changsha, China.|Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Xia
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Martha
authors.initials: M
authors.lastname: Campbell-Thompson
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Clive H
authors.initials: CH
authors.lastname: Wasserfall
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Kieran
authors.initials: K
authors.lastname: McGrail
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Amanda
authors.initials: A
authors.lastname: Posgai
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Schultz
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Brusko
authors.affiliation: Department of Health Outcomes and Policy, University of Florida, Gainesville, FL.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shuster
authors.affiliation: Department of Biostatistics, University of Florida, Gainesville, FL.
authors.forename: Faming
authors.initials: F
authors.lastname: Liang
authors.affiliation: Department of Pediatrics, Emory University, Atlanta, GA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Muir
authors.affiliation: Department of Pediatrics, University of Florida, Gainesville, FL.
authors.forename: Desmond
authors.initials: D
authors.lastname: Schatz
authors.affiliation: Department of Pediatrics, University of Florida, Gainesville, FL.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Haller
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL atkinson@ufl.edu.|Department of Pediatrics, University of Florida, Gainesville, FL.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Atkinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000503:physiopathology; D014362:Trypsinogen / Q000097:blood*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D014362:Trypsinogen