Persistence of Prolonged C-peptide Production in Type 1 Diabetes as Measured With an Ultrasensitive C-peptide Assay  

Oleh:

Wang, Limei ; Lovejoy, Nicholas Fraser ; Faustman, Denise L.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 35 no. 03 (Mar. 2012), page 465-470.
Topik: ß-cell function

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE To examine persistence of C-peptide production by ultrasensitive assay years after onset of type 1 diabetes and factors associated with preserving ß-cell function. RESEARCH DESIGN AND METHODS Serum C-peptide levels, a marker of insulin production and surviving ß-cells, were measured in human subjects (n = 182) by ultrasensitive assay, as was ß-cell functioning. Twenty-two times more sensitive than standard assays, this assay’s lower detection limit is 1.5 pmol/L. Disease duration, age at onset, age, sex, and autoantibody titers were analyzed by regression analysis to determine their relationship to C-peptide production. Another group of four patients was serially studied for up to 20 weeks to examine C-peptide levels and functioning. RESULTS The ultrasensitive assay detected C-peptide in 10% of individuals 31–40 years after disease onset and with percentages higher at shorter duration. Levels as low as 2.8 ± 1.1 pmol/L responded to hyperglycemia with increased C-peptide production, indicating residual ß-cell functioning. Several other analyses showed that ß-cells, whose C-peptide production was formerly undetectable, were capable of functioning. Multivariate analysis found disease duration (ß = -2.721; P = 0.005) and level of zinc transporter 8 autoantibodies (ß = 0.127; P = 0.015) significantly associated with C-peptide production. Unexpectedly, onset at >40 years of age was associated with low C-peptide production, despite short disease duration. CONCLUSIONS The ultrasensitive assay revealed that C-peptide production persists for decades after disease onset and remains functionally responsive. These findings suggest that patients with advanced disease, whose ß-cell function was thought to have long ceased, may benefit from interventions to preserve ß-cell function or to prevent complications.

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