Immunoreactive Trypsin(ogen) in the Sera of Children with Recent-Onset Insulin-Dependent Diabetes and Matched Controls.
Landin-Olsson, Mona; Borgstrom, Anders; Blom, Leif; Sundkvist, Goran; Lernmark, Ake; The Swedish Childhood Diabetes Group *
5(3):241-247, May 1990.
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Summary: To evaluate the exocrine pancreatic function at the time of diagnosis of insulin-dependent diabetes mellitus, we determined immunoreactive anodal and cathodal trypsin(ogen) levels in sera from almost all children (n = 375) 0-14 years of age in Sweden in whom diabetes developed during 1 year, and in sex-, age-, and geographically matched control subjects (n = 312). The median level of anodal trypsin(ogen) was 5 (quartile range, 3-7) [mu]g/L in children with newly diagnosed diabetes, compared with a median level of 7 (quartilerange, 4-8) pg/L in control subjects (p < 0.0001). Similarly, the median level of cathodal trypsin(ogen) was 8 (quartile range, 4-10) kg/L in children with diabetes, compared with a median level of 11 (quartile range, 7-15) pgL in control subjects (p < 0.0001). The median of the individual ratios between cathodal and anodal trypsin(ogen) was 1.4 in the diabetic patients and 1.7 in the control children (p < 0.001). In a multivariate test, however, only the decrease in cathodal trypsin(ogen) concentration was associated with diabetes. The levels of trypsin(ogen)s did not correlate with levels of islet cell antibodies, present in 81% of the diabetic children. Several mechanisms may explain our findings, for example, similar pathogenetic factors may affect both the endocrine and exocrine pancreas simultaneously, a failing local trophic stimulation by insulin on the exocrine cells may decrease the trypsinogen production, and there may be an increased elimination of trypsin(ogen) because of higher fdtration through the kidneys in the hyperglycemic state.
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