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Home Urine C-Peptide Creatinine Ratio Can Be Used to Monitor Islet Transplant Function

Lookup NU author(s): Dr Gus Brooks, Professor James Shaw

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Abstract

OBJECTIVEIslet graft function is defined by serum C-peptide in a standardized challenge test. We assessed whether urine C-peptide creatinine ratio (UCPCR) sent from home could provide a viable alternative.RESEARCH DESIGN AND METHODSSeventeen islet recipients provided 90-min serum C-peptide (sCP90) and 120-min UCPCR (UCPCR120) samples during 68 interval posttransplant mixed-meal tolerance tests, also posting from home a 120-min postbreakfast UCPCR sample every 2 weeks. UCPCR was compared with a clinical score of islet function, derived from HbA1c and insulin dose.RESULTSUCPCR120 and mean home postmeal UCPCR were strongly correlated with sCP90 (r(s) = 0.73, P < 0.001; and r(s) = 0.73, P < 0.01, respectively). Mean home UCPCR increased with clinical score (r(s) = 0.75; P < 0.001) and with graft function defined both by sCP90 > 200 pmol/L and insulin independence. UCPCR cutoffs to detect insulin independence and poor graft function were sensitive and specific.CONCLUSIONSHome UCPCR provides a valid measure of C-peptide production in islet transplant recipients.

Publication metadata

Author(s): Oram RA, Brooks AM, Forbes S, Eckoldt S, Smith RM, Choudhary P, Rosenthal MJ, Johnson P, Rutter MK, Burling KA, McDonald TJ, Shaw JAM, Hattersley AT

Publication type: Article

Publication status: Published

Journal: Diabetes Care

Year: 2014

Volume: 37

Issue: 6

Pages: 1737-1740

Print publication date: 01/06/2014

Online publication date: 12/03/2014

Acceptance date: 27/01/2014

ISSN (print): 0149-5992

ISSN (electronic): 1935-5548

Publisher: American Diabetes Association

URL: http://dx.doi.org/10.2337/dc13-1266

DOI: 10.2337/dc13-1266

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