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Circulating L-selectin concentrations in children with recent-onset IDDM
1Department of General Pediatrics, Charité Medical Center, Virchow Hospital, Humboldt University, Berlin, Germany.
Insights
Serum soluble L-selectin (sCD62L) levels are slightly elevated in recent-onset type 1 diabetes but this finding is obscured by age-related changes. This suggests sCD62L measurements have limited clinical value in pediatric diabetes management.
Area of Science:
- Immunology
- Endocrinology
- Pediatrics
Background:
- Conflicting reports exist regarding serum concentrations of soluble L-selectin (sCD62L) in recent-onset type 1 diabetes mellitus (IDDM).
- sCD62L is a marker of leukocyte activation, potentially relevant in inflammatory conditions like diabetes.
- Age significantly influences sCD62L levels, complicating interpretation in pediatric populations.
Purpose of the Study:
- To investigate and clarify altered serum sCD62L concentrations in children and adolescents with recent-onset IDDM.
- To assess the relationship between sCD62L levels, IDDM status, and age.
- To determine the clinical utility of sCD62L measurements in pediatric IDDM.
Main Methods:
- Serum sCD62L concentrations were measured in 89 children and adolescents with IDDM (categorized by disease duration) and 124 age-matched controls.
- Participants included recent-onset IDDM, those within the first year of insulin treatment, and those with long-standing IDDM.
- Multivariate analysis was employed to assess the association between sCD62L, age, and IDDM status.
Main Results:
- Younger children (< 14 years) exhibited significantly higher sCD62L concentrations compared to adolescents and adults, irrespective of diabetes status.
- A strong inverse association was confirmed between chronological age and sCD62L levels (p < 0.001).
- Recent-onset IDDM patients showed slightly elevated sCD62L compared to insulin-treated IDDM patients and non-diabetic controls (p = 0.028), a finding masked by age effects.
Conclusions:
- While a minor increase in systemic sCD62L in recent-onset IDDM suggests leukocyte activation, it is significantly confounded by age.
- The strong inverse correlation between age and sCD62L in pediatric populations limits its diagnostic value.
- Serum sCD62L measurement holds limited clinical value for researchers and clinicians managing pediatric IDDM.
Abstract:
To clarify conflicting claims of altered serum concentrations of soluble L-selectin (sCD62L) in recent-onset IDDM, sCD62L was measured in 89 children and adolescents with IDDM (35 recent-onset, 12 during the first year of insulin treatment, and 42 with long-standing (> 1 yr) treatment) alongside 124 controls. Children < 14 yr of age both with and without IDDM (n = 160) had grossly elevated sCD62L concentrations (20.2 +/- 4.9 nmol/l), as compared with adolescents (14-18 yr, n = 23; 15.9 +/- 3.9 nmol/l) and adults (> 18 yr, n = 30; 11.2 +/- 2.3 nmol/l) (p < 0.0001). Multivariate analysis confirmed the strong inverse association between age and sCD62L (p < 0.001) while revealing that sCD62L concentrations were slightly elevated in recent-onset IDDM, as compared with insulin-treated IDDM patients or nondiabetic controls (p = 0.028). Actual sCD62L concentrations in the 35 recent-onset IDDM patients were 22.2 +/- 4.9 nmol/L vs 19.6 +/- 3.6 nmol/l in 35 non-diabetic controls matched for age (p = 0.022). While this significant but small rise of systemic sCD62L reflects leukocyte activation, it is obscured by the inverse association between sCD62L and chronological age in children and adolescents. Therefore, determining sCD62L serum concentrations appears to be of limited value for clinical investigators caring for children and adolescents with IDDM.