The Course of Progranulin Levels at Admission and During Early Period of Insulin Treatment in Children with Newly Diagnosed Type 1 Diabetes Mellitus

Objective: Progranulin (PGRN), a growth factor, modulates cell proliferation, wound repair, and inflammation. It is also involved in glucose metabolism and is associated with insulin resistance and diabetes mellitus (DM). In the present study, PGRN levels were measured at admission and during follow-up in children with newly diagnosed type 1 DM (T1DM) and compared to healthy controls. Methods: Children with T1DM and healthy controls were included. The age, weight, height, body mass index (BMI), severity of acidosis, glucose, insulin, C-peptide, and diabetes-specific autoantibodies of children with newly diagnosed T1DM were collected. PGRN was measured in children with T1DM at admission, at first week of follow-up, and in healthy controls. Results: A total of 49 children were included; 25 with T1DM [12 Female/13 Male (12F/13M)] and 24 healthy controls (10F/14M). There was no differences in age (11±3.9 years vs 12.1±3.1 years, p=0.269) and BMI standard deviation (SD) score (-0.11±1.49 SD vs. 0.10±0.82 SD, p=0.540) of children with T1DM and healthy controls. The mean basal PGRN level of children with newly diagnosed T1DM was higher than in controls (90.8±17.3 ng/mL vs. 30±11.5 ng/mL, p<0.001). In children with T1DM, mean basal PGRN at admission had declined significantly (58.4±16.9 ng/mL; p<0.001) in the first week after glycemic regulation was achieved but remained significantly higher than in controls (p<0.001). Conclusion: These findings suggest that elevated PGRN levels in children with newly diagnosed T1DM may reflect either an acute inflammatory response to diabetic ketoacidosis or a persistent alteration in metabolic regulation, or both of these, highlighting the potential role of PGRN as a biomarker in the early course of T1DM.