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Children with Type 1 Diabetes of Early Age at Onset - Immune and Metabolic Phenotypes

2019-09-25Journal article Open access
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dc.contributor.authorSales Luis, M
dc.contributor.authorAlcafache, M
dc.contributor.authorFerreira, S
dc.contributor.authorFitas, AL
dc.contributor.authorSimões Pereira, J
dc.contributor.authorCaramalho, I
dc.contributor.authorLopes, L
dc.contributor.authorLimbert, C
dc.date.accessioned2021-06-24T08:37:22Z
dc.date.available2021-06-24T08:37:22Z
dc.date.issued2019-09-25
dc.description.abstractObjectives We aimed to evaluate children with type 1 diabetes (T1D) with early age at onset (EAO) for clinical, immune and metabolic features in order to identify age-related disease phenotypes. Methods Comparative study of two groups of T1D children: EAO (≤5 years) and later age at onset (LAO; >5 years), regarding the presence of other autoimmune (AI) diseases, diabetes ketoacidosis and immunologic profile at onset and metabolic data 1 year after diagnosis. Statistical analysis was performed with significance set for p < 0.05. Results The study included 137 children (EAO = 52, mean age 3.6 ± 1.5 [mean ± standard deviation (SD)] and LAO = 85, mean age 10.4 ± 2.9). EAO was more associated with concomitant AI diseases (p = 0.032). Despite no differences in disease onset, EAO presented with lower C-peptide levels (p = 0.01) and higher absolute lymphocyte number (p < 0.0001), with an inverse correlation between these two variables (p = 0.028). Additionally, the EAO group had a higher frequency of serum detection of three antibodies (Abs) (p = 0.0008), specifically insulin Abs (p = 0.0001). One year after diagnosis, EAO had higher total daily insulin (TDI) dose (p = 0.008), despite similar hemoglobin A1c (HbA1c). Conclusions Our data show an association of EAO T1D with more AI diseases, higher number of Abs, lower initial insulin reservoir and higher insulin requirements 1 year after diagnosis. In this group, immune imbalance seems more evident and disease progression faster, probably reflecting distinct "immune environment" with different ages at disease onset. Further studies in the field of immunogenetics and immune tolerance are required, to improve patient stratification and find novel targets for therapeutic intervention.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Pediatr Endocrinol Metab.2019;32(9):935-941pt_PT
dc.identifier.doi10.1515/jpem-2019-0103pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3747
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherDe Gruyterpt_PT
dc.subjectAdolescentpt_PT
dc.subjectAge of Onsetpt_PT
dc.subjectAutoantibodiespt_PT
dc.subjectAutoimmune Diseasespt_PT
dc.subjectBiomarkerspt_PT
dc.subjectBlood Glucosept_PT
dc.subjectC-Peptidept_PT
dc.subjectChildpt_PT
dc.subjectChild, Preschoolpt_PT
dc.subjectDiabetes Mellitus, Type 1pt_PT
dc.subjectDiabetic Ketoacidosispt_PT
dc.subjectFemalept_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectGlycated Hemoglobin Apt_PT
dc.subjectHumanspt_PT
dc.subjectHypoglycemic Agentspt_PT
dc.subjectInfantpt_PT
dc.subjectInfant, Newbornpt_PT
dc.subjectInsulinpt_PT
dc.subjectMalept_PT
dc.subjectPhenotypept_PT
dc.subjectPrognosispt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectHDE END PEDpt_PT
dc.titleChildren with Type 1 Diabetes of Early Age at Onset - Immune and Metabolic Phenotypespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage941pt_PT
oaire.citation.issue9pt_PT
oaire.citation.startPage935pt_PT
oaire.citation.titleJournal of pediatric endocrinology & metabolism : JPEMpt_PT
oaire.citation.volume32pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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