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Effect of overweight status at onset on C-peptide levels during first 2 years since diagnosis in children with type 1 diabetes

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 (Unpublished)

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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:
CreatorsEmailPitt UsernameORCID
Wang, Junyaojuw55@pitt.eduJUW55
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Thesis AdvisorArena, Vincent C.arena@pitt.eduARENA
Committee MemberTalbott, Evelyn O.eot1@pitt.eduEOT1
Committee MemberPike, Francispikef@upmc.eduFRP3
Committee MemberLibman, Ingrid M.ingrid.libman@chp.eduIML1
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: Graduate 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: 15 Nov 2016 14:32
URI: http://d-scholarship.pitt.edu/id/eprint/27470

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