Islet Autoantibodies and Their Association with β Cell Function and Diabetes Measures in Children with Acute Recurrent and Chronic Pancreatitis

Objective: In children with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) circulating islet autoantibodies (Ab) may influence β-cell function. This study reports Ab prevalence in youth with ARP/CP, and investigates effects on indices of insulin secretion during mixed meal tolerance testing (MMTT) and diabetes mellitus (DM) status. Research Design and Methods: This was a retrospective cross-sectional analysis of 234 youth with ARP/CP who had islet Ab testing. Ab+ group n=28 (12%) and Ab- group n=206 (88%). Fasting glucose and HbA1c were collected. MMTT was performed in 78% (183/234). MMTT derived indices were calculated and compared between groups. Results: The Ab+ and Ab- groups did not differ in age, sex, race, ethnicity, body mass index percentile or fasting glucose. Of Ab+ patients, 54% had one Ab+ and 46% had multiple Ab+. Comparing Ab+ to Ab- group: HbA1c was higher (median 5.7 vs 5.2%, p<0.01) and C-peptide was lower (median 2.4 vs 3.7 ng/ml), p=0.01). The Ab+ compared to the Ab- group had a higher proporition of preDM/DM (57%;vs. 32%, p<0.001) . In survival analysis, Ab+ group had significantly shorter time from first acute pancreatitis episode to DM development (p=0.02). Conclusions: In children with ARP/CP Ab+ was associated with higher risk of preDM/DM development, and shorter time to DM development, suggesting that islet Ab+ is associated with β cell dysfunction in this patient cohort. Islet Ab+ was also associated with higher HbA1C and lower C-peptide levels. Future studies are needed to validate the role of islet Ab postivity in pancreatitis.