Literature DB >> 25287319

Partial remission definition: validation based on the insulin dose-adjusted HbA1c (IDAA1C) in 129 Danish children with new-onset type 1 diabetes.

Marie Louise C Max Andersen1, Philip Hougaard, Sven Pörksen, Lotte B Nielsen, Siri Fredheim, Jannet Svensson, Jane Thomsen, Jennifer Vikre-Jørgensen, Thomas Hertel, Jacob S Petersen, Lars Hansen, Henrik B Mortensen.   

Abstract

OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset of type 1 diabetes (T1D). Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive value of IDAA1c and age on partial C-peptide remission (stimulated C-peptide, SCP > 300 pmol/L).
RESULTS: PR (IDAA1c ≤ 9) in the Danish and Hvidoere cohorts occurred in 62 vs. 61% (3 months, p = 0.80), 47 vs. 44% (6 months, p = 0.57), 26 vs. 32% (9 months, p = 0.32) and 19 vs. 18% (12 months, p = 0.69). The effect of age on SCP was significantly higher in the Danish cohort compared with the Hvidoere cohort (p < 0.0001), likely due to higher attained Boost SCP, so the sensitivity and specificity of those in PR by IDAA1c ≤ 9, SCP > 300 pmol/L was 0.85 and 0.62 at 6 months and 0.62 vs. 0.38 at 12 months, respectively. IDAA1c with age significantly improved the ROC analyses and the AUC reached 0.89 ± 0.04 (age) vs. 0.94 ± 0.02 (age + IDAA1c) at 6 months (p < 0.0004) and 0.76 ± 0.04 (age) vs. 0.90 ± 0.03 (age + IDAA1c) at 12 months (p < 0.0001).
CONCLUSIONS: The diagnostic and prognostic power of the IDAA1c measure is kept but due to the higher Boost stimulation in the Danish cohort, the specificity of the formula is lower with the chosen limits for SCP (300 pmol/L) and IDAA1c ≤9, respectively.
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Entities:  

Keywords:  C-peptide; children; definition for partial remission; diabetes mellitus; type 1

Mesh:

Substances:

Year:  2014        PMID: 25287319     DOI: 10.1111/pedi.12208

Source DB:  PubMed          Journal:  Pediatr Diabetes        ISSN: 1399-543X            Impact factor:   4.866


  27 in total

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Authors:  Siri Fredheim; Marie-Louise M Andersen; Sven Pörksen; Lotte B Nielsen; Christian Pipper; Lars Hansen; Jens J Holst; Jane Thomsen; Jesper Johannesen; Henrik B Mortensen; Jannet Svensson
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7.  Mechanisms and early patterns of dyslipidemia in pediatric type 1 and type 2 diabetes.

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Authors:  Jannet Svensson; Stine Møller Sildorf; Christian B Pipper; Julie N Kyvsgaard; Julie Bøjstrup; Flemming M Pociot; Henrik B Mortensen; Karsten Buschard
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10.  Features of partial remission in children with type 1 diabetes using the insulin dose-adjusted A1c definition and risk factors associated with nonremission.

Authors:  Tsz Wai Catherine Wong; Man Yee Shirley Wong; Wai Man Betty But
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