Islet Autoantibodies and Their Association With b-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 (auto-Ab) may influence b-cell function. This study reports Ab prevalence in youth with ARP or CP and investigates effects on indices of insulin secretion during mixed meal tolerance testing (MMTT) and diabetes status. RESEARCH DESIGN AND METHODS This was a retrospective cross-sectional analysis of 234 youth with ARP or CP who had islet Ab testing (Ab⁺ group, n = 28 [12%]; Ab^- group, n = 206 [88%]). Fasting glu cose and HbA1c were collected. MMTT was performed in 78% of participants (183 of 234). MMTT-derived indices were calculated and compared between groups. RESULTS The Ab⁺ and Ab^- groups did not differ in age, sex, race, ethnicity, BMI percentile, or fasting glucose. Of Ab+ patients, 54% had one Ab+ islet and 46% had multiple Ab+ islets. Comparing the Ab+ to Ab^- groups, 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)intheAb⁺ group. The Ab+ compared with the Ab^- group had a higher proportion of prediabetes/dia betes (57% vs. 32%, P 0.001). In survival analysis, the Ab⁺ group had significantly shorter time from first acute pancreatitis episode to diabetes development (P = 0.02). CONCLUSIONS In children with ARP or CP, Ab⁺ was associated with higher risk of diabetes/diabetes development and shorter time to diabetes development, suggesting that islet Ab+ is associated with b-cell dysfunction in this patient cohort. Islet Ab+ was also associ ated with higher HbA1c and lower C-peptide levels. Future studies are needed to vali date the role of islet Ab positivity in pancreatitis.