Beta cell function and BMI in ethnically diverse children with newly diagnosed autoimmune type 1 diabetes

Authors

  • Maria J. Redondo,

    Corresponding author
    • Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
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  • Luisa M. Rodriguez,

    1. Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
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  • Mirna Escalante,

    1. Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
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  • E. O'Brian Smith,

    1. Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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  • Ashok Balasubramanyam,

    1. Department of Medicine, Section of Endocrinology and Diabetes, Baylor College of Medicine, Houston, TX, USA
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  • Morey W. Haymond

    1. Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
    2. Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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Corresponding author:

Maria Jose Redondo, MD

Department of Pediatrics

Diabetes and Endocrinology, Texas

Children's Hospital

6701 Fannin Street, Suite 1020

Houston, TX 77030

USA

Tel: +832 822 1019;

fax: +832 825 3903;

e-mail: redondo@bcm.edu

Abstract

Objective

To examine the relationship between BMI and beta-cell function at diagnosis of autoimmune type 1 diabetes (T1D) in a large group of ethnically diverse children.

Methods

Cross-sectional analysis of 524 children (60.8% White, 19.5% Hispanic, 14.5% African-American, 5.2% other non-Hispanic; mean age = 9.8 yr [SD = 2.5]) with newly diagnosed autoimmune T1D.

Results

As much as 22.2% of children were overweight or obese. Median random serum C-peptide was 0.40 ng/mL (25th–75th percentiles = 0.3–0.8), with median glycemia of 366 mg/dL (25th–75th percentiles = 271–505). Median C-peptide was 0.3, 0.5, 0.7, and 0.85 ng/mL, respectively, in underweight, normal weight, overweight, and obese children (p < 0.0001, Kruskal–Wallis). In the final model (p < 0.0001), the odds of having preserved C-peptide (≥0.6 ng/mL) were increased by 2.4-fold (95% CI = 1.2–4.9, p < 0.015) and 4.1-fold (1.9–8.5, p < 0.0001), respectively, in overweight and obese compared to lean children; 1.3-fold per each year of age; 2.5-fold in girls compared to boys; 4-fold in children who presented without, compared to with, diabetes ketoacidosis (DKA); and decreased by 21% for each point increase in HbA1c. Tanner stage, race/ethnicity, glycemia, and number of anti-islet antibodies expressed were not independently associated with preserved C-peptide. The association between BMI and C-peptide levels was significant in children with and without preserved C-peptide. Excluding patients who presented with DKA and/or using BMI obtained 5 wk after diagnosis did not alter the results.

Conclusion

Obese and overweight children compared to lean children have greater beta-cell function at the onset of autoimmune T1D. Prospective studies on the relationships among BMI, beta-cell function, and progression to clinical T1D are warranted.

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