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Levels of C-peptide, body mass index and age, and their usefulness in classification of diabetes in relation to autoimmunity, in adults with newly diagnosed diabetes in Kronoberg, Sweden

Thunander, Maria LU ; Torn, Carina; Petersson, Christer; Ossiansson, Birger; Fornander, Jan and Landin-Olsson, Mona LU (2012) In European Journal of Endocrinology 166(6). p.1021-1029
Abstract
Objective: C-peptide is a main outcome measure in treatment trials of diabetes. C-peptide also has a role in the classification of diabetes, which is often difficult in adults and this is also increasingly recognised in adolescents and elders. Aim: We aimed to describe the levels of C-peptide in relation to age and body mass index (BMI) in a large population-based cohort of adults with newly diagnosed diabetes and compare the capabilities of C-peptide, age and BMI to discriminate between autoimmune and non-autoimmune diabetes. Subjects and methods: Blood samples from 1180 patients were analysed regarding islet cell antibody, glutamic acid decarboxylase antibody and fasting C-peptide (FCP). Receiver operating characteristics (ROC) curves... (More)
Objective: C-peptide is a main outcome measure in treatment trials of diabetes. C-peptide also has a role in the classification of diabetes, which is often difficult in adults and this is also increasingly recognised in adolescents and elders. Aim: We aimed to describe the levels of C-peptide in relation to age and body mass index (BMI) in a large population-based cohort of adults with newly diagnosed diabetes and compare the capabilities of C-peptide, age and BMI to discriminate between autoimmune and non-autoimmune diabetes. Subjects and methods: Blood samples from 1180 patients were analysed regarding islet cell antibody, glutamic acid decarboxylase antibody and fasting C-peptide (FCP). Receiver operating characteristics (ROC) curves were analysed to check the ability of age, BMI and C-peptide to discriminate between autoantibody-positive (Ab(+)) and -negative (Ab(-)) diabetes. Results: Mean FCP was 0.73 +/- 0.5 (range 0.13-1.80) nmol/l in the Ab(+) and 1.42 +/- 0.9 (range 0.13-8.30) nmol/l in the Ab(-). FCP was 0.02 nmol/l higher per year increase in age at diagnosis of diabetes. Mean BMI was 26.0 +/- 4.8 (range 18.0-39.0) kg/m(2) in the Ab(+) and 28.9 +/- 5.3 (range 15.5-62.6) kg/m(2) in the Ab(-). FCP increased with age also within each BMI group. The highest area under the curve (AUC) in the ROC analysis was found for C-peptide, followed by age and BMI (0.78, 0.68 and 0.66 respectively). Conclusions: At diagnosis of diabetes, C-peptide was superior to age and BMI in discriminating between autoimmune and non-autoimmune diabetes. C-peptide increased significantly with BMI and age, latter also within each BMI group. Most of the adults had normal or high levels of C-peptide at presentation of diabetes among the autoimmune patients. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Endocrinology
volume
166
issue
6
pages
1021 - 1029
publisher
Society of the European Journal of Endocrinology
external identifiers
  • wos:000304541100008
  • scopus:84862740212
ISSN
1479-683X
DOI
10.1530/EJE-11-0797
language
English
LU publication?
yes
id
f1443316-eac9-40df-a708-7892cecea03d (old id 2890577)
date added to LUP
2012-08-01 08:56:33
date last changed
2017-11-19 03:18:37
@article{f1443316-eac9-40df-a708-7892cecea03d,
  abstract     = {Objective: C-peptide is a main outcome measure in treatment trials of diabetes. C-peptide also has a role in the classification of diabetes, which is often difficult in adults and this is also increasingly recognised in adolescents and elders. Aim: We aimed to describe the levels of C-peptide in relation to age and body mass index (BMI) in a large population-based cohort of adults with newly diagnosed diabetes and compare the capabilities of C-peptide, age and BMI to discriminate between autoimmune and non-autoimmune diabetes. Subjects and methods: Blood samples from 1180 patients were analysed regarding islet cell antibody, glutamic acid decarboxylase antibody and fasting C-peptide (FCP). Receiver operating characteristics (ROC) curves were analysed to check the ability of age, BMI and C-peptide to discriminate between autoantibody-positive (Ab(+)) and -negative (Ab(-)) diabetes. Results: Mean FCP was 0.73 +/- 0.5 (range 0.13-1.80) nmol/l in the Ab(+) and 1.42 +/- 0.9 (range 0.13-8.30) nmol/l in the Ab(-). FCP was 0.02 nmol/l higher per year increase in age at diagnosis of diabetes. Mean BMI was 26.0 +/- 4.8 (range 18.0-39.0) kg/m(2) in the Ab(+) and 28.9 +/- 5.3 (range 15.5-62.6) kg/m(2) in the Ab(-). FCP increased with age also within each BMI group. The highest area under the curve (AUC) in the ROC analysis was found for C-peptide, followed by age and BMI (0.78, 0.68 and 0.66 respectively). Conclusions: At diagnosis of diabetes, C-peptide was superior to age and BMI in discriminating between autoimmune and non-autoimmune diabetes. C-peptide increased significantly with BMI and age, latter also within each BMI group. Most of the adults had normal or high levels of C-peptide at presentation of diabetes among the autoimmune patients.},
  author       = {Thunander, Maria and Torn, Carina and Petersson, Christer and Ossiansson, Birger and Fornander, Jan and Landin-Olsson, Mona},
  issn         = {1479-683X},
  language     = {eng},
  number       = {6},
  pages        = {1021--1029},
  publisher    = {Society of the European Journal of Endocrinology},
  series       = {European Journal of Endocrinology},
  title        = {Levels of C-peptide, body mass index and age, and their usefulness in classification of diabetes in relation to autoimmunity, in adults with newly diagnosed diabetes in Kronoberg, Sweden},
  url          = {http://dx.doi.org/10.1530/EJE-11-0797},
  volume       = {166},
  year         = {2012},
}