Serological markers of exocrine pancreatic function are differentially informative for distinguishing individuals progressing to type 1 diabetes
Authors' conclusion
Among the serological markers tested, lipase and trypsinogen levels were the most informative for differentiating among clinical groups, with the utility of each enzyme varying according to GRS2 and AAb/T1D status. These data support exocrine pancreas enzymes as candidates for longitudinal follow-up.
Study context
- Population
- Individuals aged 2.7–30.0 years with T1D, islet AAb positivity or AAb negativity; serum assessed for IGF1, IGF2, adiponectin, leptin, amylase, lipase and trypsinogen
- Participants
- 543 individuals
- Exposure
- Serum biomarkers, AAb and genetic risk score (GRS2) across AAb/T1D status groups
- T1Dn = 154
- 1AAb+n = 56
- ≥2AAb+n = 77
- AAb-n = 256
- Outcome
- Utility of biomarkers combined with AAb and GRS2 in predicting AAb/T1D status
Methodological detailsrandom forest modeling
- Random forest modeling
Main finding
As reported in the abstract
Most informative markers for AAb/T1D classification
- Higher GRS2 favored ≥2AAb+ vs AAb- classification
- p<0.001
- Lower lipase favored ≥2AAb+ vs AAb- classification
- p=0.002
- AAb against ZnT8 favored ≥2AAb+ vs 1AAb+ classification
- p<0.01
- AAb against GAD65 favored ≥2AAb+ vs 1AAb+ classification
- p=0.021
- AAb against insulin favored ≥2AAb+ vs 1AAb+ classification
- p=0.01
- Reduced trypsinogen favored recent-onset T1D vs ≥2AAb+ classification
- p<0.001
- Increased lipase favored recent-onset T1D vs ≥2AAb+ classification
- p<0.001
Observational data: associations, not effects.
Original publication
Serological markers of exocrine pancreatic function are differentially informative for distinguishing individuals progressing to type 1 diabetes. BMJ Open Diabetes Res Care. Published 4 January 2025. doi:10.
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