Endocrine Abstracts

Objectives: Broad insight into metabolic disturbances caused by diabetes ketoacidosis (DKA) and persist after pH normalization.

Methods: Three groups of children with type 1 diabetes were recruited: after an episode of DKA (DKA, n=20), with established diabetes (EDM, n=10) and with new onset diabetes without DKA (NDM, n=10). EDM and NDM groups were matched to the DKA one for sex and age. Serum samples were collected at three time points: 0-24h-72h since the admission for DKA and NDM groups and once for EDM patients. Metabolic fingerprinting was performed with LC-QTOF-MS (Agilent 6550 iFunnel).

Results and Conclusions: After technical filtering 248 metabolomic features out of 712 (in positive ionization) and 295 out of 652 (in negative ionization) were suitable for between-group comparisons. Statistical analysis selected 22 metabolic features as putative biomarkers of episodes of DKA occurrence in nearest 72h. From those features 4 metabolites were successfully identified – 3 with higher after DKA episode versus comparative groups: lysophosphatidylocholine (LPC) (18:1), sphingomieline (SM) (34:0), SM (d18:0/15:0) and one with lower level – LPC (18:0). Measurement of LPC (18:1) and LPC (18:0) were proposed as diagnostic test of past DKA episode with area under curve (AUC) equaling 0.88 (95%CI 0.81–0.95), sensitivity 79.1% (95% CI 63.5–89.4%) and specificity 85.0% (95%CI 69.5–93.8%). Metabolic disturbances caused by diabetes ketoacidosis episode may last up to 72 hours and may further distress organisms of children with type 1 diabetes.

The study was financially supported by a Scientific Grant from Diabetes Poland.