Proinsulin-to-C-peptide ratio linked to progression to T1DM
Emily K. Sims, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues examined whether elevation in the PI:C ratio correlated with type 1 diabetes. Samples were obtained about 12 months before onset of diabetes from 60 TrialNet Pathway to Prevention progressors in whom diabetes developed and 58 age-, sex-, and body mass index (BMI)-matched nonprogressors who remained normoglycemic.
The researchers found that, compared with nonprogressors, there was a significant increase in PI:C ratios in antibody-positive subjects in whom there was progression to diabetes (median, 1.81 versus 1.17 percent; P = 0.03). Subjects who were ≤10 years old had the most pronounced difference between groups; 90 percent of subjects in this age group within the upper PI:C ratio quartile progressed to diabetes development. The odds of progression were increased for higher natural log PI:C ratio values after adjustment for age and BMI (odds ratio, 1.44).
"These data suggest that β-cell endoplasmic reticulum dysfunction precedes type 1 diabetes onset, especially in younger children," the authors write. "Elevations in the serum PI:C ratio may have utility in predicting the onset of type 1 diabetes in the presymptomatic phase."
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