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Relationship Between Overweight Status at Onset and Insulin Reserve in Childen with Type 1 Diabetes

Xu, Jia (2012) Relationship Between Overweight Status at Onset and Insulin Reserve in Childen with Type 1 Diabetes. Master's Thesis, University of Pittsburgh. (Unpublished)

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Abstract

Background: The incidence rate of Type 1 Diabetes (T1DM) is increasing in line with the obesity epidemic in children. It remains unknown whether being overweight is associated with greater insulin reserve at the onset of the disease and how this impacts disease progression.
Objective: To evaluate the relationship between overweight status at onset and insulin reserve in children and adolescents with T1DM.
Methods: This study is a prospective follow-up study of new onset T1DM patients (aged 1.5 to 18.9 years) identified from the Children’ Hospital of Pittsburgh (CHP) Registry. This study invited all children aged <19 years, newly diagnosed with T1DM from 2004 to 2006 at CHP to participate. The main outcome of interest was C-peptide levels at the onset of T1DM and at 3-month, 6-month, 12-month, 18-month, and 24-month follow up visits. We evaluated the independent associations between C-peptide levels and overweight status at baseline using generalized estimating equation (GEE) regression models.
Results: Complete data were available in 179 subjects. The patients were on average 9.5 years old at enrollment, with 22% (39) overweight, defined as body mass index ≥85th percentile for the same gender and age. Mean C-peptide levels in the study population was 0.65ng/ml at baseline. C-peptide levels increased at the 3-month follow up visit and then gradually decreased at subsequent follow-up visits. GEE models suggested a statistically significant interaction between overweight status at baseline and follow-up visits after adjustment of potential confounders. C-peptide concentrations were significantly higher for overweight compared to non-overweight participants at 3-month, 6-month, 18-month follow up visits and borderline significant at the 12-month follow up visit.
Conclusion: Overweight T1DM children had higher C-peptide levels as compared to non-overweight T1DM children at 3-month, 6-month, 12-month, and 18-month follow up visits; however, at 24-months after initiation of treatment, the C-peptide levels between overweight and non-overweight groups were not statistically significant different any longer.
Public health significance: Overweight patients with T1DM may potentially benefit from target preventive strategies that will help them maintain or prolong the high C-peptide levels after initiation of treatment.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Xu, Jiajix25@pitt.eduJIX25
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairArena, Vincentarena@pitt.eduARENA
Committee MemberYouk, Adaayouk@pitt.eduAYOUK
Committee MemberLibman, IngridIngrid.Libman@chp.eduIML1
Date: 2 July 2012
Date Type: Completion
Defense Date: 25 April 2012
Approval Date: 2 July 2012
Submission Date: 2 May 2012
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 100
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: Type 1 Diabetes, Overweight, Children
Date Deposited: 02 Jul 2012 13:57
Last Modified: 02 Jul 2017 05:15
URI: http://d-scholarship.pitt.edu/id/eprint/12094

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