Genetic Associations With C-peptide Levels Before Type 1 Diabetes Diagnosis in At-risk Relatives

J Clin Endocrinol Metab. 2025 Mar 17;110(4):e1046-e1050. doi: 10.1210/clinem/dgae349.

Abstract

Objective: We sought to determine whether the type 1 diabetes genetic risk score-2 (T1D-GRS2) and single nucleotide polymorphisms are associated with C-peptide preservation before type 1 diabetes diagnosis.

Methods: We conducted a retrospective analysis of 713 autoantibody-positive participants who developed type 1 diabetes in the TrialNet Pathway to Prevention Study who had T1DExomeChip data. We evaluated the relationships of 16 known single nucleotide polymorphisms and T1D-GRS2 with area under the curve (AUC) C-peptide levels during oral glucose tolerance tests conducted in the 9 months before diagnosis.

Results: Higher T1D-GRS2 was associated with lower C-peptide AUC in the 9 months before diagnosis in univariate (β = -.06, P < .0001) and multivariate (β = -.03, P = .005) analyses. Participants with the JAZF1 rs864745 T allele had lower C-peptide AUC in both univariate (β = -.11, P = .002) and multivariate (β = -.06, P = .018) analyses.

Conclusion: The type 2 diabetes-associated JAZF1 rs864745 T allele and higher T1D-GRS2 are associated with lower C-peptide AUC before diagnosis of type 1 diabetes, with implications for the design of prevention trials.

Keywords: C-peptide; epidemiology; genetic risk score; genetics; prediction; prevention; type 1 diabetes.

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / blood
  • C-Peptide* / blood
  • Child
  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / diagnosis
  • Diabetes Mellitus, Type 1* / genetics
  • Family
  • Female
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • Glucose Tolerance Test
  • Humans
  • Male
  • Polymorphism, Single Nucleotide*
  • Retrospective Studies
  • Young Adult

Substances

  • C-Peptide
  • Autoantibodies