Clinical and immunological factors influencing the onset and course of partial remission in pediatric type 1 diabetes

Semine Özdemir Dilek; İhsan Turan; Fatih Gürbüz; Eda Mengen; Can Celiloğlu; Bilgin Yüksel

Makale detayları

Clinical and immunological factors influencing the onset and course of partial remission in pediatric type 1 diabetes

Yazarlar:

Semine Özdemir Dilek | İhsan Turan | Fatih Gürbüz | Eda Mengen | Can Celiloğlu | Bilgin Yüksel

Yayıncı:

Cukurova University

Ana Başlıklar:

Çocuk Endokrinolojisi

Dergi:

Cukurova Medical Journal Vol.50 Issue 3, pp.863-871

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357857

pISSN:

2602-3032

Anahtar kelimeler:

Özet:

 Purpose: This study examined key clinical and immunological factors influencing the onset and course of partial remission PR in children and adolescents with newly diagnosed type 1 diabetesT1D. Materials and Methods: A total of 201 pediatric patients with T1D were enrolled. PR was defined as an insulin dose-adjusted HbA1cIDAA1c of9. Participants were categorized into two groups: PR and NR non-remission. Results: Partial remission occurred in 138 69 patients. In the PR group, the mean age at diagnosis was 9.4  3.8 years, with PR onset occurring 1.6  1.4 months after diagnosis and lasting for a mean duration of 7.3  5.2 months. Overweightobesity was strongly associated with PR, as 81 of overweightobese patients achieved remission. Anti-glutamic acid decarboxylase anti-GAD antibody positivity was more frequent in the PR group 63.0 vs. 33.3. Longer remission was seen in patients with puberty, overweightobesity, or coeliac disease, whereas positivity for anti-GAD and islet cell antibodies was associated with shorter remission. Conclusion: Anti-GAD and ICA antibodies have distinct effects on PR, reflecting the complexity of autoimmune activity in pediatric T1D. The presence of obesity, puberty, and celiac disorder supports the need for a immuno-metabolic strategy for the early prediction and management of PR in pediatric T1D.

 Purpose: This study examined key clinical and immunological factors influencing the onset and course of partial remission PR in children and adolescents with newly diagnosed type 1 diabetesT1D. Materials and Methods: A total of 201 pediatric patients with T1D were enrolled. PR was defined as an insulin dose-adjusted HbA1cIDAA1c of9. Participants were categorized into two groups: PR and NR non-remission. Results: Partial remission occurred in 138 69 patients. In the PR group, the mean age at diagnosis was 9.4  3.8 years, with PR onset occurring 1.6  1.4 months after diagnosis and lasting for a mean duration of 7.3  5.2 months. Overweightobesity was strongly associated with PR, as 81 of overweightobese patients achieved remission. Anti-glutamic acid decarboxylase anti-GAD antibody positivity was more frequent in the PR group 63.0 vs. 33.3. Longer remission was seen in patients with puberty, overweightobesity, or coeliac disease, whereas positivity for anti-GAD and islet cell antibodies was associated with shorter remission. Conclusion: Anti-GAD and ICA antibodies have distinct effects on PR, reflecting the complexity of autoimmune activity in pediatric T1D. The presence of obesity, puberty, and celiac disorder supports the need for a immuno-metabolic strategy for the early prediction and management of PR in pediatric T1D.

 Purpose: This study examined key clinical and immunological factors influencing the onset and course of partial remission PR in children and adolescents with newly diagnosed type 1 diabetesT1D. Materials and Methods: A total of 201 pediatric patients with T1D were enrolled. PR was defined as an insulin dose-adjusted HbA1cIDAA1c of9. Participants were categorized into two groups: PR and NR non-remission. Results: Partial remission occurred in 138 69 patients. In the PR group, the mean age at diagnosis was 9.4  3.8 years, with PR onset occurring 1.6  1.4 months after diagnosis and lasting for a mean duration of 7.3  5.2 months. Overweightobesity was strongly associated with PR, as 81 of overweightobese patients achieved remission. Anti-glutamic acid decarboxylase anti-GAD antibody positivity was more frequent in the PR group 63.0 vs. 33.3. Longer remission was seen in patients with puberty, overweightobesity, or coeliac disease, whereas positivity for anti-GAD and islet cell antibodies was associated with shorter remission. Conclusion: Anti-GAD and ICA antibodies have distinct effects on PR, reflecting the complexity of autoimmune activity in pediatric T1D. The presence of obesity, puberty, and celiac disorder supports the need for a immuno-metabolic strategy for the early prediction and management of PR in pediatric T1D.

 Amaç: Bu çalışmada yeni tanı konmuş tip 1 diyabetli T1D çocuk ve ergenlerde parsiyel remisyonun PR başlangıcını ve seyrini şekillendiren klinik ve immünolojik faktörleri incelenmiştir. Gereç ve Yöntem: Çalışmaya T1D tanısı almış toplam 201 pediatrik hasta dahil edildi. PR, insülin dozu ile ayarlanmış HbA1c IDAA1c 9 olarak tanımlandı. Katılımcılar parsiyel remisyon yaşayanlar PR grubu ve remisyon yaşamayanlar NR grubu olmak üzere iki gruba ayrıldı. Bulgular: Parsiyel remisyon 138 69 hastada gözlendi. PR grubunda tanı anındaki ortalama yaş 9,4  3,8 yıl olup, remisyon başlangıcı tanıdan ortalama 1,6  1,4 ay sonra gerçekleşmiş ve ortalama 7,3  5,2 ay sürmüştür. Fazla kiloluobez olmak PR ile güçlü bir şekilde ilişkiliydi; fazla kiloluobez hastaların 81inde parsiyel remisyon görüldü. Anti-glutamik asit dekarboksilaz anti-GAD antikor pozitifliği PR grubunda daha sık saptandı 63,0 iken 33,3. Daha uzun remisyon süresi ergenlik dönemindeki, fazla kiloluobez olan veya çölyak hastalığı pozitif olan hastalarda gözlenirken; anti-GAD ve adacık hücre antikoru pozitifliği daha kısa remisyon ile ilişkiliydi. Sonuç: Bulgularımız, anti-GAD ve ICA gibi iyi bilinen belirteçlerin bile, çocukluk çağı T1Dde PRnin seyri üzerinde farklı yönlü etkiler gösterebileceğini, bu belirteçlerin öngörüsel karmaşıklığını ve klinik önemini vurgulamaktadır. Ayrıca obezite, ergenlik ve çölyak hastalığı arasındaki etkileşim, T1Dnin başlangıç döneminde PR yönetiminde immünometabolik yaklaşımların gerekliliğini ortaya koymaktadır.

Makale detayları

Clinical and immunological factors influencing the onset and course of partial remission in pediatric type 1 diabetes

Yazarlar:

Semine Özdemir Dilek | İhsan Turan | Fatih Gürbüz | Eda Mengen | Can Celiloğlu | Bilgin Yüksel

Yayıncı:

Cukurova University

Ana Başlıklar:

Çocuk Endokrinolojisi

Dergi:

Cukurova Medical Journal Vol.50 Issue 3, pp.863-871

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357857

pISSN:

2602-3032

partial remission

anti-glutamic acid decarboxylase antibody

islet cell antibody: parsiyel remisyon

anti-glutamik asit dekarboksilaz antikoru

adacık hücresi antikoru

ergenlik

fazla kilo

obezite

Sayı

Makale detayları

Yazarlar: Semine Özdemir Dilek | İhsan Turan | Fatih Gürbüz | Eda Mengen | Can Celiloğlu | Bilgin Yüksel

Yayıncı: Cukurova University

Ana Başlıklar: Çocuk Endokrinolojisi

Dergi: Cukurova Medical Journal Vol.50 Issue 3, pp.863-871

Belge Tipi: Makale

Yayın Tarihi: 9/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001357857

pISSN: 2602-3032

Sayı

Yazarlar:

Semine Özdemir Dilek | İhsan Turan | Fatih Gürbüz | Eda Mengen | Can Celiloğlu | Bilgin Yüksel

Yayıncı:

Cukurova University

Ana Başlıklar:

Çocuk Endokrinolojisi

Dergi:

Cukurova Medical Journal Vol.50 Issue 3, pp.863-871

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001357857

pISSN:

2602-3032