October - December 2008, Volume 4, Issue 4

Serban V, Vlad A, Rosu M, Rosca A, Timar R, Sima A

Decrease of pancreatic antibodies and fasting C peptide in Romanian children with type I diabetes mellitus is related to disease duration

Acta Endo (Buc) 2008, 4 (4): 367-381
doi: 10.4183/aeb.2008.367

The prerequisite for developing methods for type 1 diabetes mellitus prevention is to know its pathogenic mechanisms. The aim of this work was to characterize a group of children with type 1 diabetes mellitus regarding pancreatic antibody positivity and fasting C peptide concentrations. The study group enrolled 117 children, 61 boys (52.1%), mean age 12.7?3.1 years. Islet cell antibodies, glutamic acid decarboxylase antibodies (GADA), IA-2 antibodies (IA-2A) and fasting C peptide were measured. Sensitivity for GADA and IA-2A tests was 85% and 75%, respectively. Specificity for the tests was 87.1% and 98%, respectively. The threshold for pancreatic antibody positivity was considered the 97.5th percentile, and normal values for fasting C peptide were between the 5th and 95th percentiles from a control group (n=73), matched for age and gender. Thirty-nine patients (33.3%) were positive for 1 antibody, 10 (8.6%) were positive for 2 and 2 (1.7%) were positive for all 3 antibodies. The positivity for pancreatic antibodies and for islet cell antibodies was significantly lower in patients with diabetes duration>2 years, compared with the rest: 32% vs. 52.2% (p=0.03) and 6% vs. 20.9% (p=0.03), respectively. Mean fasting C peptide and the percentage of patients with normal C peptide decreased significantly one year after the diagnosis of diabetes: 0.20?0.40 ng/ml vs. 0.44?0.57 ng/ml (p=0.03) and 9.5% vs. 27.3% (p=0.02), respectively. In conclusion, in children with type 1 diabetes mellitus, pancreatic autoimmunity is more intense in the first two years of the disease and insulin secretion decreases one year after the diagnosis.

Keywords: type I diabetes mellitus, pancreatic antibodies, C peptide, prevention

Correspondence: A. Vlad, MD, “Victor Babes” University of Medicine and Pharmacy, Department for Diabetes, County Hospital, B-dul Dr. Iosif Bulbuca 10, 300736, Timisoara, Romania. Phone: +40- 723010065, Fax: +40-356433377, E-mail: vladrian@hotmail.com