Children who develop type 1 diabetes early in life show low levels of carnitine and amino acids at birth: does this finding shed light on the etiopathogenesis of the disease?

Abstract

Background:Children and adolescents with overt type 1 diabetes (T1D) have been found to show an altered carnitine profile. This pattern has not previously been analyzed in neonates before onset of the disease.Materials and methods:Fifty children who developed T1D during the first 6 years of life, born and living in the Tuscany and Umbria Regions of Italy, were identified and 200 controls were recruited into the study. All newborns were subjected to extended neonatal screening by mass spectrometry at 48–72 h of life. Four controls for each of the 50 index cases were taken randomly and blinded in the same analytical batch. The panel used for neonatal screening consists of 13 amino acids, free carnitine, 33 acyl-carnitines and 21 ratios. All Guthrie cards are analyzed within 2 days of collection.Results:Total and free carnitine were found to be significantly lower in neonates who later developed T1D compared with controls. Moreover, the concentrations of the acyl-carnitines – acetyl-L-carnitine (C2), proprionylcarnitine (C3), 3-hydroxyisovalerylcarnitine (C5OH), miristoylcarnitine (C4), palmitoylcarnitine (C16) and stearoylcarnitine (C18) – were also significantly low in the cases vs controls. Furthermore, total amino-acid concentrations, expressed as the algebraic sum of all amino acids tested, showed a trend toward lower levels in cases vs controls.Conclusions:We found that carnitine and amino-acid deficit may be evident before the clinical appearance of T1D, possibly from birth. The evaluation of these metabolites in the neonatal period of children human leukocyte antigen genetically at ‘risk' to develop T1D, could represent an additional tool for the prediction of T1D and could also offer the possibility to design new strategies for the primary prevention of the disease from birth.

Serum Amino Acid Profiles in Normal Subjects and in Patients with or at Risk of Alzheimer Dementia

“…1), several previous studies have reported low Glu concentrations in plasma or serum of AD [15, 30, 44, 45] and MCI [15, 40] patients in comparison with HS. In contrast, Miulli et al [18] demonstrated a significant increase in Glu in plasma, while others did not find significant differences in serum [17, 46, 47] of AD patients compared with that of controls.…”

Metabolic heritability at birth: implications for chronic disease research

“…There is emerging evidence that acylcarnitine and amino acid levels captured at birth through newborn screening can be useful for prediction of complex conditions such as type 1 diabetes (la Marca et al , 2013); however, to our knowledge no study exists examining the association between levels captured at birth and laterlife development of chronic disease. We were also limited to examination of only the metabolite markers captured by the newborn screen.…”

Significance of l‐carnitine for human health

“…However, baseline plasma level of C2carnitine does not predict the risk of developing type 2 diabetes in prospective analysis (41). In a case-control study, plasma level of total and free L-carnitine is lower in neonates who later develop type 1 diabetes compared to control neonates (87).…”