173-LB: Circulating Calprotectin Is Increased in Children with T1D and Obesity—Implications for T1D Progression and Outcome

Purpose: Circulating calprotectin is elevated in inflammatory disorders and is a biomarker of severity in inflammatory rheumatic and bowel diseases. Calprotectin has immunomodulatory properties that may influence the progression and outcome of inflammatory diseases. Calprotectin is elevated in children with obesity, but its levels in children with T1D co-morbid with obesity remain unexplored. We examined the levels of circulating calprotectin in children with T1D and obesity and compared these levels with those of children with normal weight as well as those with obesity and T2D or children with obesity only (no prediabetes or T2D).

Methods: Sixty-four children (aged 5-13 years) were included. Participants' characteristics included being of normal weight (body mass index, BMI <85th percentile; n = 12), having obesity (BMI ≥95th percentile) with T1D (n = 4), obesity with T2D (n = 8), or having obesity without prediabetes or diabetes (n = 40). Clinical markers were assessed using established procedures on peripheral blood. The levels of calprotectin were quantified using commercially available ELISA kits.

Results: Circulating calprotectin was significantly (P = 0.0044) higher in children with T1D and obesity, as well as in children with T2D and obesity (P = 0.02), compared to healthy children with normal weight. There was no difference in calprotectin levels between children with T1D and obesity compared to those with T2D and obesity or obesity without prediabetes or diabetes.

Conclusion: Increased calprotectin in children with T1D (as well as T2D) is due to the obese state and is not further increased by having diabetes. Given the immunomodulatory properties of calprotectin, obesity in children with T1D might hasten disease progression, resulting in a worse outcome. These findings highlight the need for tailored obesity prevention in children with high risk for T1D and emphasize the importance of treatment strategies for weight management in children with T1D.