The Bright Side of Skin Autofluorescence Determination in Children and Adolescents with Newly Diagnosed Type 1 Diabetes Mellitus: A Potential Predictor of Remission?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Size Calculation
2.2. Participants
2.3. Demographic and Clinical Data
2.4. Biochemical Analyses
2.5. Skin Autofluorescence
2.6. Hospitalization and Initiation of the Insulin Treatment
2.7. Statistical Analysis
3. Results
3.1. Group Characteristics
3.2. Variables at the Time of DM Diagnosis
3.3. Follow-Up Study
3.4. Effects of Diabetic Ketoacidosis
3.5. Remitters vs. Non-Remitters Group
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All | No Remission | Remission | p | |
---|---|---|---|---|
n (%, CI) | 114 | 70 (61.4, CI: 52.2–69.8) | 44 (38.6, CI: 30.2–47.8) | NA |
Sex, boys (%) | 64 (56) | 39 (56) | 25 (57) | 1.000 |
AT DIABETES DIAGNOSIS | ||||
BMI SDS | −0.5 ± 1.1 | −0.7 ± 0.9 | −0.1 ± 1.0 | <0.001 |
Age, years | 8.0 ± 4.5 | 7.3 ± 4.3 | 9.1 ± 4.7 | 0.041 |
HbA1c, % (mmol/mol) | 11.9 ± 2.4 (107 ± 27) | 12.0 ± 2.6 (108 ± 28) | 11.9 ± 2.2 (106 ± 24) | 0.786 |
C-peptide, pmol/L | 133.5; 80.5–219.5 | 121.0; 65.2–193.7 | 158.5; 99.7–255.7 | 0.019 |
C-peptide/glucose ratio | 13.7; 6.5–24.8 | 10.3; 5.5–22.1 | 14.8; 9.8–27.0 | 0.032 |
Diabetic ketoacidosis, yes (%) | 53 (46) | 35 (50) | 18 (41) | 0.441 |
Antibodies, positive (%) | 107 (94) | 66 (94) | 41 (93) | 1.000 |
Skin autofluorescence, arbitrary units | 1.01 ± 0.23 | 1.04 ± 0.26 | 0.95 ± 0.18 | 0.027 |
Insulin daily dose at discharge (IU/kg/24 h) | 0.5 ± 0.2 | 0.6 ± 0.3 | 0.5 ± 0.2 | 0.034 |
Duration of remission (days) | NA | NA | 201 ± 199 | 0.001 |
FOLLOW-UP AFTER 1 YEAR OF DIABETES DURATION | ||||
HbA1c, % (mmol/mol) | 7.6 ± 1.2 (60 ± 13) | 7.9 ± 1.2 (63 ± 13) | 7.1 ± 1.0 (54 ± 11) | 0.236 |
Delta HbA1c, % (mmol/mol) | −4.3 ± 2.6 (−47 ± 29) | −4.1 ± 2.8 (−45 ± 31) | −4.7 ± 2.2 (−50 ± 25) | <0.001 |
Mean HbA1c, % (mmol/mol) | 8.4 ± 0.9 (68 ± 11) | 8.7 ± 0.9 (72 ± 10) | 7.8 ± 0.8 (62 ± 9) | <0.001 |
C-peptide, pmol/L | 121.0; 12.7–297.0 | 78.0; 9.2–202.5 | 263.5; 99.2–425.7 | <0.001 |
C-peptide/glucose ratio | 13.7; 1.4–30.4 | 6.5; 1.0–17.6 | 20.4; 9.7–53.8 | <0.001 |
Insulin daily dose, IU/kg/24 h | 0.6 ± 0.2 | 0.7 ± 0.2 | 0.5 ± 0.2 | <0.001 |
All (n = 74) | Siblings (n = 43) | Non-Siblings (n = 31) | p | |
---|---|---|---|---|
Age, years | 7.9 ± 4.5 | 7.3 ± 3.9 | 8.6 ± 5.1 | 0.228 |
Sex, boys (%) | 38 (51) | 21 (49) | 17 (55) | 0.644 |
SAF (arbitrary units) | 0.88 ± 0.19 | 0.88 ± 0.2 | 0.88 ± 0.18 | 0.883 |
T1D (n = 114) | Controls (n = 74) | p | |
---|---|---|---|
Age, years | 8.0 ± 4.5 | 7.9 ± 4.5 | 0.805 |
Sex, boys (%) | 64 (56) | 38 (51) | 0.551 |
SAF (arbitrary units) | 1.01 ± 0.23 | 0.88 ± 0.19 | p < 0.001 |
Step | Parameter | ΔR2 | Standardized β | p Value |
---|---|---|---|---|
Independent variables: age, HbA1c, and SAF at DM diagnosis | ||||
Dependent variable: HbA1c change in 1 year of DM duration (R2 = 0.786; p < 0.001; n = 113) | ||||
1 | HbA1c | 0.786 | 0.232 | <0.001 |
Dependent variable: C-peptide after 1 year of DM duration (R2 = 0.434; p < 0.001; n = 114) | ||||
1 | age | 0.413 | 0.601 | <0.001 |
HbA1c | 0.021 | 0.167 | 0.025 | |
Dependent variable: C-peptide/glucose ratio after 1 year of DM duration (R2 = 0.421; p < 0.001; n = 114) | ||||
1 | age | 0.401 | 0.593 | <0.001 |
2 | HbA1c | 0.020 | 0.165 | 0.029 |
Step | Parameter | ΔR2 | β (CI) | p Value |
---|---|---|---|---|
Dependent variable: remission (R2 = 0.140; p = 0.002; n = 114) | ||||
Independent variables: age, HbA1c, and SAF at DM diagnosis | ||||
1 | SAF | 0.051 | 0.051 (0.007–0.390) | 0.004 |
2 | age | 0.089 | 1.151 (1.040–1.273) | 0.007 |
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Podolakova, K.; Barak, L.; Jancova, E.; Stanik, J.; Sebekova, K.; Podracka, L. The Bright Side of Skin Autofluorescence Determination in Children and Adolescents with Newly Diagnosed Type 1 Diabetes Mellitus: A Potential Predictor of Remission? Int. J. Environ. Res. Public Health 2022, 19, 11950. https://doi.org/10.3390/ijerph191911950
Podolakova K, Barak L, Jancova E, Stanik J, Sebekova K, Podracka L. The Bright Side of Skin Autofluorescence Determination in Children and Adolescents with Newly Diagnosed Type 1 Diabetes Mellitus: A Potential Predictor of Remission? International Journal of Environmental Research and Public Health. 2022; 19(19):11950. https://doi.org/10.3390/ijerph191911950
Chicago/Turabian StylePodolakova, Kristina, Lubomir Barak, Emilia Jancova, Juraj Stanik, Katarina Sebekova, and Ludmila Podracka. 2022. "The Bright Side of Skin Autofluorescence Determination in Children and Adolescents with Newly Diagnosed Type 1 Diabetes Mellitus: A Potential Predictor of Remission?" International Journal of Environmental Research and Public Health 19, no. 19: 11950. https://doi.org/10.3390/ijerph191911950