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Serological markers of exocrine pancreatic function are differentially informative for distinguishing individuals progressing to type 1 diabetes.

Authors :
Williams MD
Grace CR
Posgai AL
McGrail KM
Brusko MA
Haller MJ
Jacobsen L
Schatz D
Brusko TM
Atkinson M
Bacher R
Wasserfall CH
Source :
BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2025 Jan 04; Vol. 13 (1). Date of Electronic Publication: 2025 Jan 04.
Publication Year :
2025

Abstract

Introduction: Altered serum levels of growth hormones, adipokines, and exocrine pancreas enzymes have been individually linked with type 1 diabetes (T1D). We collectively evaluated seven such biomarkers, combined with islet autoantibodies (AAb) and genetic risk score (GRS2), for their utility in predicting AAb/T1D status.<br />Research Design and Methods: Cross-sectional serum samples (n=154 T1D, n=56 1AAb+, n=77 ≥2AAb+, n=256 AAb-) were assessed for IGF1, IGF2, adiponectin, leptin, amylase, lipase, and trypsinogen (n=543, age range 2.7-30.0 years) using random forest modeling.<br />Results: GRS2, age, lipase, trypsinogen, and AAb against ZnT8, GAD65, and insulin were the most informative markers. Notably, these variables were differentially informative according to AAb/T1D status. Higher GRS2 (p<0.001) and lower lipase levels (p=0.002) favored ≥2AAb+ versus AAb- classification. AAb against ZnT8 (p<0.01), GAD65 (p=0.021), or insulin (p=0.01) each independently favored ≥2AAb+ versus 1AAb+ classification. Reduced trypsinogen (p<0.001) and increased lipase levels (p<0.001) favored recent-onset T1D versus ≥2AAb+ classification.<br />Conclusions: Among the serological markers tested, lipase and trypsinogen levels were the most informative for differentiating among clinical groups, with the utility of each enzyme varying according to GRS2 and AAb/T1D status. These data support exocrine pancreas enzymes as candidates for longitudinal follow-up.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Details

Language :
English
ISSN :
2052-4897
Volume :
13
Issue :
1
Database :
MEDLINE
Journal :
BMJ open diabetes research & care
Publication Type :
Academic Journal
Accession number :
39755561
Full Text :
https://doi.org/10.1136/bmjdrc-2024-004655