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Randomized Controlled Trial
. 2014 Jul;37(7):1959-65.
doi: 10.2337/dc13-2603. Epub 2014 Apr 23.

Distribution of C-peptide and its determinants in North American children at risk for type 1 diabetes

Ping Xu  1 , Xiaoning Qian  2 , Desmond A Schatz  3 , David Cuthbertson  2 , Jeffrey P Krischer  2 ; DPT-1 Study Group
Affiliations
Randomized Controlled Trial

Distribution of C-peptide and its determinants in North American children at risk for type 1 diabetes

Ping Xu et al. Diabetes Care. 2014 Jul.

Abstract

Objective: To determine basal and stimulated C-peptide percentiles in North American children and adolescents at risk for type 1 diabetes (T1D) and to examine factors associated with this distribution in the Diabetes Prevention Trial-Type 1 (DPT-1).

Research design and methods: We included 582 subjects aged 4-18 years at randomization in the DPT-1 trials. A 2-h oral glucose tolerance test (OGTT) was performed at baseline and every 6 months during the 5-year follow-up period. The percentile values of C-peptide after baseline OGTT were estimated according to age, BMI Z score (BMIZ), and/or sex categories. Conditional quantile regression was used to examine the relationship between C-peptide percentiles and various independent variables.

Results: The basal and stimulated C-peptide levels increased significantly as age and BMIZ increased (P < 0.05). Both age and BMIZ had a stronger impact on the upper quartile of C-peptide distributions than the lower quartile. Sex was only significantly associated with stimulated C-peptide. Higher stimulated C-peptide levels were generally observed in girls compared with boys at the same age and BMIZ (P < 0.05). HLA type and number of positive antibodies and antibody titers (islet cell antibody [ICA], insulin autoantibody, GAD65A, and ICA512A) were not significantly associated with C-peptide distribution after adjustment for age, BMIZ, and sex.

Conclusions: Age-, sex-, and BMIZ-specific C-peptide percentiles can be estimated for North American children and adolescents at risk for T1D. They can be used as an assessment tool that could impact the recommendations in T1D prevention trials.

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Figures

Figure 1
Figure 1
Effect of age, BMIZ, and/or sex on C-peptide by quantile. A: Effect on basal C-peptide (age 4–8 vs. 9–18 years, BMIZ <85.0 vs. ≥85.0 percentile) (estimated parameter by quantile for baseline fasting C-peptide with 95% CI). B: Effect on stimulated C-peptide (sex female vs. male; age 4–8 vs. 9–18 years; BMIZ <85.0 vs. ≥85.0 percentile) (estimated parameter by quantile for baseline peak C-peptide with 95% CI).
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