{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:17:59Z","timestamp":1787987879995,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Congenital Hyperinsulinism (CHI) is associated with inappropriately high levels of C\u2010peptide in the context of hypoglycemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to better clarify a diagnostic threshold value of C\u2010peptide for children presenting with CHI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This was a retrospective case\u2010control analysis, examining all hypoglycemia screens, undertaken between 2009 and 2019 at a quaternary paediatrics unit. Plasma C\u2010peptide, insulin, free fatty acid (FFA) and B\u2010hydroxybutyrate (BHOB) concentrations in children diagnosed with CHI were compared with concentrations in children diagnosed with other conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>All patients requiring hypoglycaemic screens at the quaternary children's hospital were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median [C\u2010peptide] were statistically significantly different between CHI (147) and non\u2010CHI (72) patients, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05. The Youden Index indicated that a [C\u2010peptide] value of 291.5\u2009pmol\/L would give the greatest optimization of sensitivity (82%) and specificity (99%) for detecting CHI. Median [insulin] differed significantly between the cohorts with a level of 64\u2009pmol\/L for CHI patients compared with 0\u2009pmol\/L with non\u2010CHI patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Median [BOHB] was 0\u2009\u03bcmol\/L in CHI patients as compared with 2378\u2009\u03bcmol\/L for non\u2010CHI patients (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Median [FFA] levels were 1910\u2009\u03bcmol\/L in the non\u2010CHI cohort, compared with 0 in the CHI cohort (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggests that a C\u2010peptide concentration greater than 291.5\u2009pmol\/L is diagnostic of CHI in children. C\u2010peptide appears to offer the greatest utility as a biochemical diagnostic test for CHI and could be prioritised for laboratory analysis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15137","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T10:43:39Z","timestamp":1727952219000},"page":"129-135","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Biomarkers and Diagnostic Thresholds for Congenital Hyperinsulinism"],"prefix":"10.1111","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4588-6792","authenticated-orcid":false,"given":"Grace","family":"Petkovic","sequence":"first","affiliation":[{"name":"Department of Paediatric Endocrinology Alder Hey Children's Hospital Liverpool 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