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Ghrelin, obestatin poor predictors of metabolic control in pediatric type 1 diabetes
In children with type 1 diabetes, the peptides acylated ghrelin, unacylated ghrelin and obestatin appear to be regulated by acute changes in glucose metabolism and are not useful long-term predictors of metabolic control, according to recent study findings.
The longitudinal study recruited 51 consecutive patients evaluated at the division of pediatrics at Maggiore della Carita Hospital in Novara, Italy, from December 2008 to April 30, 2010. All patients were diagnosed with type 1 diabetes based on standard benchmarks. A control group consisting of 33 healthy, age-matched participants was also enrolled.
Children in the type 1 diabetes group were assessed longitudinally for 2 years after the initial visit, for the purpose of evaluating glucose and metabolic profiles. Measurements of acylated ghrelin, unacylated ghrelin and obestatin were taken at baseline, and two subsequent visits were aimed at determining whether baseline acylated ghrelin, unacylated ghrelin and obestatin were predictive of future glucose and metabolic control.
The findings were adjusted for variables such as age, BMI and stage of puberty at baseline.
The researchers found that after adjusting for age, BMI and pubertal stage, unacylated ghrelin levels were lower in children with type 1 diabetes compared with controls (P<.005), and obestatin concentrations were higher vs. controls (P<.009). Children with diabetes had acylated ghrelin levels that were comparable to controls, but the balance of the three, when conveyed as ratios, was changed in the children with diabetes. Inverse relationships were identified between obestatin (P<.05) and C-peptide (P<.05) and insulin autoantibodies (P<.008) at the initial stage of diabetes, suggesting a role in pancreas regulation. Baseline acylated ghrelin and unacylated ghrelin in the group with diabetes were negatively associated with insulin dosage in both the short and long term (P<.001). Two years after diagnosis, there was a direct correlation between acylated ghrelin and C-peptide levels (P<.05), but not obestatin.
The researchers said acylated ghrelin, unacylated ghrelin and obestatin seem to be primarily regulated by acute rather than chronic changes in glucose metabolism, thus making them poor long-term predictors of glucose or metabolic control.
“Further investigations in wider datasets, in subgroups of patients with respect to C-peptide decrease and in relatives, will clarify whether [obestatin] could be a precocious predictor of islet dysfunction and/or a protective peptide in vivo in humans,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.