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 (auto-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 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 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+ and 46% had multiple Ab+. 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) in the Ab+ group. The Ab+ compared with the Ab− group had a higher proportion of prediabetes/diabetes (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/CP, Ab+ was associated with higher risk of diabetes/diabetes development, and shorter time to diabetes 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 positivity in pancreatitis.