Islet Autoantibodies and Their Association with β Cell Function and Diabetes Measures in Children with Acute Recurrent and Chronic Pancreatitis

Le résumé fourni par la source

Objective: In children with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) circulating islet autoantibodies (Ab) may influence β-cell function. This study reports Ab prevalence in youth with ARP/CP, and investigates effects on indices of insulin secretion during mixed meal tolerance testing (MMTT) and diabetes mellitus (DM) status. Research Design and Methods: This was a retrospective cross-sectional analysis of 234 youth with ARP/CP who had islet Ab testing. Ab+ group n=28 (12%) and Ab- group n=206 (88%). Fasting glucose and HbA1c were collected. MMTT was performed in 78% (183/234). MMTT derived indices were calculated and compared between groups. Results: The Ab+ and Ab- groups did not differ in age, sex, race, ethnicity, body mass index percentile or fasting glucose. Of Ab+ patients, 54% had one Ab+ and 46% had multiple Ab+. Comparing Ab+ to Ab- group: HbA1c was higher (median 5.7 vs 5.2%, p<0.01) and C-peptide was lower (median 2.4 vs 3.7 ng/ml), p=0.01). The Ab+ compared to the Ab- group had a higher proporition of preDM/DM (57%;vs. 32%, p<0.001) . In survival analysis, Ab+ group had significantly shorter time from first acute pancreatitis episode to DM development (p=0.02). Conclusions: In children with ARP/CP Ab+ was associated with higher risk of preDM/DM development, and shorter time to DM development, suggesting that islet Ab+ is associated with β cell dysfunction in this patient cohort. Islet Ab+ was also associated with higher HbA1C and lower C-peptide levels. Future studies are needed to validate the role of islet Ab postivity in pancreatitis.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.