J Gołębiewska1, J Solomina2, M R Kijek2, A Kotukhov2, L Basto2, K Gołąb2, P J Bachul2, E Konsur2, K Ciepły2, N Fillman2, L-J Wang2, C C Thomas3, L H Philipson3, M Tibudan2, A Krenc2, A Dębska-Ślizień4, J Fung2, P Witkowski5. 1. Department of Surgery, University of Chicago, Chicago, Illinois, USA; Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland. 2. Department of Surgery, University of Chicago, Chicago, Illinois, USA. 3. Department of Medicine, University of Chicago, Chicago, Illinois, USA. 4. Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland. 5. Department of Surgery, University of Chicago, Chicago, Illinois, USA. Electronic address: pwitkowski@surgery.bsd.uchicago.edu.
Abstract
BACKGROUND: BETA-2 score using a single fasting blood sample was developed to estimate beta-cell function after islet transplantation (ITx) and was validated internally by a high ITx volume center (Edmonton). The goal was to validate BETA-2 externally, in our center. METHODS: Areas under receiver operating characteristic curves (AUROCs) were obtained to see if beta score or BETA-2 would better detect insulin independence and glucose intolerance. RESULTS: We analyzed values from 48 mixed meal tolerance tests (MMTTs) in 4 ITx recipients with a long-term follow-up to 140 months (LT group) and from 54 MMTTs in 13 short-term group patients (ST group). AUROC for no need for insulin support was 0.776 (95% confidence interval [CI] 0.539-1, P = .02) and 0.922 (95% CI 0.848-0.996, P < .001) for beta score and 0.79 (95% CI 0.596-0.983, P = .003) and 0.941 (95% CI 0.86-1, P < .001) for BETA-2, in LT and ST groups, respectively, and did not differ significantly. In LT group BETA-2 score ≥ 13.03 predicted no need for insulin supplementation with sensitivity of 98%, specificity of 50%, positive predictive value (PPV) of 93%, and negative predictive value (NPV) of 75%. In ST group the optimal cutoff was ≥13.63 with sensitivity of 92% and specificity, PPV, and NPV 82% to 95%. For the detection of glucose intolerance BETA-2 cutoffs were <19.43 in LT group and <17.23 in ST group with sensitivity > 76% and specificity, PPV, and NPV > 80% in both groups. CONCLUSION: BETA-2 score was successfully validated externally and is a practical tool allowing for frequent and reliable assessments of islet graft function based on a single fasting blood sample.
BACKGROUND:BETA-2 score using a single fasting blood sample was developed to estimate beta-cell function after islet transplantation (ITx) and was validated internally by a high ITx volume center (Edmonton). The goal was to validate BETA-2 externally, in our center. METHODS: Areas under receiver operating characteristic curves (AUROCs) were obtained to see if beta score or BETA-2 would better detect insulin independence and glucose intolerance. RESULTS: We analyzed values from 48 mixed meal tolerance tests (MMTTs) in 4 ITx recipients with a long-term follow-up to 140 months (LT group) and from 54 MMTTs in 13 short-term group patients (ST group). AUROC for no need for insulin support was 0.776 (95% confidence interval [CI] 0.539-1, P = .02) and 0.922 (95% CI 0.848-0.996, P < .001) for beta score and 0.79 (95% CI 0.596-0.983, P = .003) and 0.941 (95% CI 0.86-1, P < .001) for BETA-2, in LT and ST groups, respectively, and did not differ significantly. In LT group BETA-2 score ≥ 13.03 predicted no need for insulin supplementation with sensitivity of 98%, specificity of 50%, positive predictive value (PPV) of 93%, and negative predictive value (NPV) of 75%. In ST group the optimal cutoff was ≥13.63 with sensitivity of 92% and specificity, PPV, and NPV 82% to 95%. For the detection of glucose intolerance BETA-2 cutoffs were <19.43 in LT group and <17.23 in ST group with sensitivity > 76% and specificity, PPV, and NPV > 80% in both groups. CONCLUSION:BETA-2 score was successfully validated externally and is a practical tool allowing for frequent and reliable assessments of islet graft function based on a single fasting blood sample.
Authors: Piotr J Bachul; Karolina Golab; Lindsay Basto; Steven Zangan; Jordan S Pyda; Angelica Perez-Gutierrez; Peter Borek; Ling-Jia Wang; Martin Tibudan; Dong-Kha Tran; Roi Anteby; Gabriela S Generette; Jędrzej Chrzanowski; Wojciech Fendler; Laurencia Perea; Kumar Jayant; Aaron Lucander; Celeste Thomas; Louis Philipson; J Michael Millis; John Fung; Piotr Witkowski Journal: Cell Transplant Date: 2021 Jan-Dec Impact factor: 4.064
Authors: Anna Lam; Richard A Oram; Shareen Forbes; Tolu Olateju; Andrew J Malcolm; Sharleen Imes; A M James Shapiro; Peter A Senior Journal: Transpl Int Date: 2022-07-06 Impact factor: 3.842