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Type: Journal article
Title: Changes in pancreatic exocrine function in young at-risk children followed to islet autoimmunity and type 1 diabetes in the ENDIA study
Author: Penno, M.A.
Oakey, H.
Augustine, P.
Taranto, M.
Barry, S.C.
Colman, P.G.
Craig, M.E.
Davis, E.A.
Giles, L.C.
Harris, M.
Haynes, A.
McGorm, K.
Morahan, G.
Morbey, C.
Rawlinson, W.D.
Sinnott, R.O.
Soldatos, G.
Thomson, R.L.
Vuillermin, P.J.
Wentworth, J.M.
et al.
Citation: Pediatric Diabetes, 2020; 21(6):945-949
Publisher: Wiley
Issue Date: 2020
ISSN: 1399-543X
Statement of
Megan Penno ... Rebecca Thomson ... Jennifer Couper ... Simon Barry ... Lynne Giles ... Helena Oakey ... et al.
Abstract: AIM: We aimed to monitor pancreatic exocrine function longitudinally in relation to the development of islet autoimmunity and type 1 diabetes in at-risk children with a first-degree relative with type 1 diabetes, who were followed prospectively in the Environmental Determinants of Islet Autoimmunity (ENDIA) study. METHODS: Fecal elastase-1 (FE-1) concentration was measured longitudinally in 85 ENDIA children from median age 1.0 (IQR 0.7,1.3) years. Twenty-eight of 85 children (progressors) developed persistent islet autoantibodies at median age of 1.5 (IQR 1.1,2.5) years, of whom 11 went on to develop clinical diabetes. The other 57 islet autoantibody-negative children (non-progressors) followed similarly were age and gender-matched with the progressors. An adjusted linear mixed model compared FE-1 concentrations in progressors and non-progressors. RESULTS: Baseline FE-1 did not differ between progressors and non-progressors, or by HLA DR type or proband status. FE-1 decreased over time in progressors in comparison to non-progressors (Wald statistic 5.46, p=0.02); in some progressors the fall in FE-1 preceded the onset of islet autoimmunity. CONCLUSIONS: Pancreatic exocrine function decreases in the majority of young at-risk children who progress to islet autoimmunity and type 1 diabetes. This article is protected by copyright. All rights reserved.
Keywords: children
exocrine pancreas
fecal elastase
islet autoimmunity
type 1 diabetes
Description: First published: 20 May 2020
Rights: © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
DOI: 10.1111/pedi.13056
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