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Age governs gender-dependent islet cell autoreactivity and predicts the clinical course in childhood IDDM

Örtqvist, E. ; Falorni, A. ; Scheynius, A. ; Persson, B. and Lernmark, Å LU (1997) In Acta Paediatrica, International Journal of Paediatrics 86(11). p.1166-1171
Abstract

Most IDDM patients temporarily restore some of their beta-cell function following the initiation of insulin therapy. The aim of this study was to analyse the influence of age, gender, metabolic state at diagnosis and presence of autoantibodies (GAD65 antibodies and ICA) on the duration of the clinical partial remission. In total, 149 consecutively diagnosed IDDM children, 0-16 y old (70F, 79M, mean age 9.5 y) were studied. Partial remission was arbitrarily defined as the period when the insulin dose was below 0.5 U/BW 24 h-1 and HbA1c below 7.5%, and occurred in 119/149 patients with a duration between 1 and 38 months. Cox's regression analysis showed that the factors significantly associated with the duration of remission... (More)

Most IDDM patients temporarily restore some of their beta-cell function following the initiation of insulin therapy. The aim of this study was to analyse the influence of age, gender, metabolic state at diagnosis and presence of autoantibodies (GAD65 antibodies and ICA) on the duration of the clinical partial remission. In total, 149 consecutively diagnosed IDDM children, 0-16 y old (70F, 79M, mean age 9.5 y) were studied. Partial remission was arbitrarily defined as the period when the insulin dose was below 0.5 U/BW 24 h-1 and HbA1c below 7.5%, and occurred in 119/149 patients with a duration between 1 and 38 months. Cox's regression analysis showed that the factors significantly associated with the duration of remission were age, gender, interaction between age and gender, ICA and a high initial HbA1c, whereas GAD65Ab had no influence. Young boys had the shortest remission period, while adolescent boys had the longest, as compared to young and adolescent girls. The ICA-negative patients (n = 42) had a longer remission period (median 9.7 months) than the ICA-positive children (n = 107; 5.0 months;p = 0.0001), regardless of GAD65Ab status. We speculate that the relative insulin resistance, which is more pronounced in pubertal girls than in boys, may be associated with a more rapid increase of exogenous insulin requirement. These findings are important when evaluating the effect of islet cell autoreactivity on the clinical course of IDDM in children.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Autoantibodies, Childhood IDDM, Clinical remission, GAD65Ab, ICA
in
Acta Paediatrica, International Journal of Paediatrics
volume
86
issue
11
pages
1166 - 1171
publisher
Wiley-Blackwell
external identifiers
  • scopus:0030716341
  • pmid:9401507
ISSN
0803-5253
DOI
10.1111/j.1651-2227.1997.tb14837.x
language
English
LU publication?
no
id
389472a3-97bd-4eff-9a2b-8922050dd7e8
date added to LUP
2019-07-01 13:18:31
date last changed
2021-02-17 01:30:12
@article{389472a3-97bd-4eff-9a2b-8922050dd7e8,
  abstract     = {<p>Most IDDM patients temporarily restore some of their beta-cell function following the initiation of insulin therapy. The aim of this study was to analyse the influence of age, gender, metabolic state at diagnosis and presence of autoantibodies (GAD65 antibodies and ICA) on the duration of the clinical partial remission. In total, 149 consecutively diagnosed IDDM children, 0-16 y old (70F, 79M, mean age 9.5 y) were studied. Partial remission was arbitrarily defined as the period when the insulin dose was below 0.5 U/BW 24 h<sup>-1</sup> and HbA1c below 7.5%, and occurred in 119/149 patients with a duration between 1 and 38 months. Cox's regression analysis showed that the factors significantly associated with the duration of remission were age, gender, interaction between age and gender, ICA and a high initial HbA1c, whereas GAD65Ab had no influence. Young boys had the shortest remission period, while adolescent boys had the longest, as compared to young and adolescent girls. The ICA-negative patients (n = 42) had a longer remission period (median 9.7 months) than the ICA-positive children (n = 107; 5.0 months;p = 0.0001), regardless of GAD65Ab status. We speculate that the relative insulin resistance, which is more pronounced in pubertal girls than in boys, may be associated with a more rapid increase of exogenous insulin requirement. These findings are important when evaluating the effect of islet cell autoreactivity on the clinical course of IDDM in children.</p>},
  author       = {Örtqvist, E. and Falorni, A. and Scheynius, A. and Persson, B. and Lernmark, Å},
  issn         = {0803-5253},
  language     = {eng},
  month        = {01},
  number       = {11},
  pages        = {1166--1171},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Paediatrica, International Journal of Paediatrics},
  title        = {Age governs gender-dependent islet cell autoreactivity and predicts the clinical course in childhood IDDM},
  url          = {http://dx.doi.org/10.1111/j.1651-2227.1997.tb14837.x},
  doi          = {10.1111/j.1651-2227.1997.tb14837.x},
  volume       = {86},
  year         = {1997},
}