Wang, Junyao
(2016)
Effect of overweight status at onset on C-peptide levels during first 2 years since diagnosis in children with type 1 diabetes.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
Background: Recently, the growing epidemic of obesity is mirrored in the increasing incidence rate of T1D in children. However, the role of overweight in the progress of T1D is still unknown.
Objective: To assess the relationship between the overweight status at onset and the insulin reserve in the first two years since diagnosis in children with T1D.
Methods: One hundred sixty-eight children newly diagnosed with T1D, aged from 1.5 to 18.9 years, with 2-years of follow-up, ≥4 autoantibodies measured at baseline, and onset C-peptide plus 3 or more follow-up measures were included in this study from the Children’s Hospital of Pittsburgh Registry (2004-2006). Baseline demographic and clinical characteristics were compared between overweight and non-overweight subjects. The change and the rate of change of C-peptide were evaluated. The contribution of being overweight to C-peptide levels and change in C-peptide from onset over time were estimated using linear mixed models adjusting for other covariates.
Results: Among the 168 subjects with mean age at 9.7 years and mean onset C-peptide of 0.76ng/mL, 22% (36) were overweight at onset with BMI ≥ 85th percentile. Onset C-peptide level of overweight subjects was higher than that of non-overweight (median: 0.88ng/mL vs. 0.50ng/mL, P<0.0001). The highest C-peptide levels (median: 1.86ng/mL vs. 1.47ng/mL, P=0.30) were observed a 3 months, followed by a continuous decline reaching the lowest level at 24 months (median: 0.29ng/mL vs. 0.18ng/mL, P=0.13). Linear mixed models suggest that the overall mean rate of change of the overweight subjects was 0.7865ng/mL/months (95% C.I.: (0.2277, 1.3452), P=0.0062) compared to the non-overweight subjects adjusting for other baseline covariates. The differences of mean C-peptide levels between these two groups decreased as time passed and reached similar levels at the end of the second year.
Conclusion: Compared to the non-overweight T1D children, overweight children had higher C-peptide levels at 3, 6, 12, and 18 months after diagnosis; however, at 24 months, this difference was not statistically significant.
Public health significance: Children with T1D who are overweight can benefit from the potential related target interventions to help them maintain or extend the duration of high C-peptide level after receiving treatment.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
29 June 2016 |
| Date Type: |
Publication |
| Defense Date: |
28 April 2016 |
| Approval Date: |
29 June 2016 |
| Submission Date: |
31 March 2016 |
| Access Restriction: |
5 year -- Restrict access to University of Pittsburgh for a period of 5 years. |
| Number of Pages: |
99 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Biostatistics |
| Degree: |
MS - Master of Science |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Type 1 diabetes, C-peptide, Overweight |
| Date Deposited: |
29 Jun 2016 19:00 |
| Last Modified: |
01 May 2021 05:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/27470 |
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