TY - JOUR
T1 - Partial Remission Definition
T2 - Validation basedon the insulin dose-adjusted HbA1c(IDAA1C) in 129 Danish Children withNew-Onset Type 1 Diabetes
AU - Andersen, Marie Louise Max
AU - Hougaard, Philip
AU - Pörksen, Sven
AU - Nielsen, Lotte B
AU - Fredheim, Siri
AU - Svensson, Jannet
AU - Thomsen, Jane
AU - Vikre-Jørgensen, Jennifer
AU - Hertel, Thomas
AU - Petersen, Jacob S.
AU - Hansen, Lars
AU - Mortensen, Henrik B
N1 - © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). Subjects and methods: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset of type 1 diabetes (T1D). Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive value of IDAA1c and age on partial C-peptide remission (stimulated C-peptide, SCP>300pmol/L). Results: PR (IDAA1c≤9) in the Danish and Hvidoere cohorts occurred in 62 vs. 61% (3months, p=0.80), 47 vs. 44% (6months, p=0.57), 26 vs. 32% (9months, p=0.32) and 19 vs. 18% (12months, p=0.69). The effect of age on SCP was significantly higher in the Danish cohort compared with the Hvidoere cohort (p<0.0001), likely due to higher attained Boost SCP, so the sensitivity and specificity of those in PR by IDAA1c≤9, SCP>300pmol/L was 0.85 and 0.62 at 6months and 0.62 vs. 0.38 at 12months, respectively. IDAA1c with age significantly improved the ROC analyses and the AUC reached 0.89±0.04 (age) vs. 0.94±0.02 (age+IDAA1c) at 6months (p<0.0004) and 0.76±0.04 (age) vs. 0.90±0.03 (age+IDAA1c) at 12months (p<0.0001). Conclusions: The diagnostic and prognostic power of the IDAA1c measure is kept but due to the higher Boost stimulation in the Danish cohort, the specificity of the formula is lower with the chosen limits for SCP (300pmol/L) and IDAA1c ≤9, respectively.
AB - Objective: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). Subjects and methods: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset of type 1 diabetes (T1D). Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive value of IDAA1c and age on partial C-peptide remission (stimulated C-peptide, SCP>300pmol/L). Results: PR (IDAA1c≤9) in the Danish and Hvidoere cohorts occurred in 62 vs. 61% (3months, p=0.80), 47 vs. 44% (6months, p=0.57), 26 vs. 32% (9months, p=0.32) and 19 vs. 18% (12months, p=0.69). The effect of age on SCP was significantly higher in the Danish cohort compared with the Hvidoere cohort (p<0.0001), likely due to higher attained Boost SCP, so the sensitivity and specificity of those in PR by IDAA1c≤9, SCP>300pmol/L was 0.85 and 0.62 at 6months and 0.62 vs. 0.38 at 12months, respectively. IDAA1c with age significantly improved the ROC analyses and the AUC reached 0.89±0.04 (age) vs. 0.94±0.02 (age+IDAA1c) at 6months (p<0.0004) and 0.76±0.04 (age) vs. 0.90±0.03 (age+IDAA1c) at 12months (p<0.0001). Conclusions: The diagnostic and prognostic power of the IDAA1c measure is kept but due to the higher Boost stimulation in the Danish cohort, the specificity of the formula is lower with the chosen limits for SCP (300pmol/L) and IDAA1c ≤9, respectively.
U2 - 10.1111/pedi.12208
DO - 10.1111/pedi.12208
M3 - Journal article
C2 - 25287319
SN - 1399-543X
VL - 15
SP - 469
EP - 476
JO - Pediatric Diabetes
JF - Pediatric Diabetes
IS - 7
ER -
