ESPE Abstracts

Background: Studies in adults with type 1 diabetes (T1D) have indicated that adiponectin is negatively associated and leptin positively associated with measures of a residual beta cell function (RBF).

Objective and hypotheses: To compare serum adiponectin and leptin levels and their ratio in children with T1D for 3–5 years with and without RBF and in healthy children.

Method: We included 342 children (173 females) with T1D, hereof 136 pre-pubertal children (15 with stimulated C-peptide above 100 pM (RBF+)) and 206 pubertal children (hereof 42 RBF+). Seventy (40 females) healthy children, hereof 40 pre-pubertal served as controls. RBF was evaluated by meal-stimulated C-peptide. We performed multiple linear regression analyses to test for differences in adiponectin, leptin and leptin/adiponectin ratio between patients (+RBF/−RBF) and healthy controls, adjusting for age, gender, BMI-SDS and HbA1c, stratified by pubertal status.

Results: In prepubertal children leptin and the leptin/adiponectin ratio were higher in RBF+ patients compared with RBF- patients and controls (all P-values <0.04). There was a trend towards elevated adiponectin levels in the RBF- group compared with the RBF+ group (P=0.07). In pubertal children adiponectin was higher in RBF- patients compared with controls (P<0.04), whereas the leptin/adiponectin ratio was lower in RBF- patients compared with controls (P<0.05). There was a trend towards the highest leptin levels in the RBF+ group (P=0.2).

Conclusion: The highest leptin levels were observed in children with T1D and a positive RBF, whereas the highest adiponectin levels were found in children with T1D without a RBF. The mechanism remain undetermined, but the characteristics of our patient population excludes higher BMI-SDS in RBF+ patients or differences in diabetes duration or kidney function between RBF+ and RBF- patients, as proposed in adults. The question remains whether children with T1D and a positive RBF share phenotypic similarities with T2D patients?