Analysis Of Factors Influencing Serum C-peptide Levels In Children With Type 1 Diabetes Mellitus

Objective: To study the related influencing factors of c-peptide in children with newly diagnosed type 1 diabetes mellitus.Through the level of c-peptide,we can further understand the relevant factors affecting islet ? cell failure,and clarify the natural process of endogenous insulin secretion(C-peptide)in children with type 1 diabetes mellitus,so as to provide new ideas for the prevention and treatment of children with type 1 diabetes mellitus and clinical diagnosis and treatment,and assist pediatric endocrinologists in the clinical diagnosis and treatment of diabetic children.Methods: The clinical data of 57 cases of newly diagnosed type 1 diabetes admitted to Shengjing Hospital affiliated to China Medical University from January 2014 to December 2018 were selected.A retrospective analysis was conducted to study the effects and intensity of gender,age,BMI,disease course,onset season,glycosylated hemoglobin,islet cell autoantibodies,diabetic ketoacidosis,thyroid diseases,blood pH and other factors on c-peptide.Results: The study has found that the onset age and course of disease are related to the level of serum c-peptide.The level of c-peptide is positively correlated with the onset age and negatively correlated with the course of disease.Gender,BMI,onset season,glycosylated hemoglobin,islet cell autoantibodies,diabetic ketoacidosis,thyroid diseases,blood pH and other factors were not found to have an impact on c-peptide.In the group of children aged 7 years or older,the median initial c-peptide level was 0.36ng/m L and the interquartile interval was 0.41ng/m L.The median level of c-peptide was 0.37ng/m L and the interquartile interval was 0.61ng/m L at 1 year of disease course.The median terminated c-peptide level was 0.29ng/m L and the interquartile interval was 0.77ng/m L at the end of follow-up.The overall median c-peptide level during the whole study was 0.41ng/m L and the interquartile interval was 0.50ng/m L.In the group of children under 7 years old,the median initial c-peptide level was 0.31ng/m L and the interquartile interval was 0.33ng/m L.The median level of c-peptide was 0.45ng/m L and the interquartile interval was 0.18ng/m L at 1 year of disease course.The median terminated c-peptide level was 0.04ng/m L and the interquartile interval was 0.14ng/m L at the end of follow-up.The overall median c-peptide level during the whole study was 0.11ng/m L and the interquartile interval was 0.29ng/m L.The statistical results of data comparison between the two groups were all p<0.05,suggesting that the difference in c peptide level between the two groups had statistical significance.The later the onset age was,the higher the initial c-peptide level was and the slower it decreased with time.With the prolongation of the course of disease,c-peptide gradually decreased,and the level of c-peptide basically decreased to 0 after the course of disease exceeded 5 years,suggesting that endogenous insulin secretion ability of diabetic children was basically completely lost.Conclusion: This study shows that the level of C peptide is positively correlated with the onset age and negatively correlated with the course of disease.Most children with newly diagnosed type 1 diabetes will basically lose their endogenous insulin secretion ability during the duration of the disease.The onset age may have some positive effects on the secretion process of endogenous insulin.