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- Title
BMI is an important driver of β-cell loss in type 1 diabetes upon diagnosis in 10 to 18-year-old children.
- Authors
Lauria, A.; Barker, A.; Schloot, N.; Hosszufalusi, N.; Ludvigsson, J.; Mathieu, C.; Mauricio, D.; Nordwall, M.; Van der Schueren, B.; Mandrup-Poulsen, T.; Scherbaum, W. A.; Weets, I.; Gorus, F. K.; Wareham, N.; Leslie, R. D.; Pozzili, P.
- Abstract
Objetive: Body weight-related insulin resistance probably plays a role in progression to type 1 diabetes, but has an uncertain w impact following diagnosis. In this study, we investigated whether BMI measured at diagnosis was an independent predictor of C-peptide decline 1-year post-diagnosis. Design: Multicentre longitudinal study carried out at diagnosis and up to 1-year follow-up. Methods: Data on C-peptide were collected from seven diabetes centres in Europe. Patients were grouped according to age at diagnosis (<5 years, n = 126; >5 years <10 years, n = 295; >10 years < 18 years, n = 421; >18 years, n = 410). Linear regression was used to investigate whether BMI was an independent predictor of change in fasting C-peptide over 1 year. Models were additionally adjusted for baseline insulin dose and HbA1c. Results: In individuals diagnosed between 0 and 5 years, 5 and 10 years and those diagnosed >18 years, we found no association between BMI and C-peptide decline. In patients aged 10-18 years, higher BMI at baseline was associated with a greater decline in fasting C-peptide over 1 year with a decrease (ß 95% CI; P value) of 0.025 (0.010, 0.041) nM/kg per m² higher baseline BMI (P=0.001). This association remained significant after adjusting for gender and differences in HbA1c and insulin dose (b = 0.026, 95% CI = 0.0097, 0.042; P=0.002). Conclusions: These observations indicate that increased body weight and increased insulin demand are associated with more rapid disease progression after diagnosis of type 1 diabetes in an age group 10-18 years. This should be considered in studies of ß-cell function in type 1 diabetes.
- Subjects
TYPE 1 diabetes; DIABETES in children; BODY mass index; PANCREATIC beta cells; INSULIN resistance; C-peptide; DIAGNOSIS
- Publication
European Journal of Endocrinology, 2015, Vol 172, Issue 2, p107
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-14-0522