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[TNF-α and soluble receptor TNF-α type 1 in children with diabetes mellitus type 1]
Mieczysław Szalecki1, Ewa Pańkowska, Elżbieta Piontek
1Klinika Endokrynologii i Diabetologii Instytutu Pomnik-Centrum Zdrowia Dziecka w Warszawie. mszalecki@wp.pl
Insights
Tumor necrosis factor-alpha (TNF-α) levels were lower in children with type 1 diabetes mellitus (DMT1), correlating with height. Soluble TNFR1 (sTNFR1) levels were higher in DMT1 children, correlating with anthropometric measures, with neither marker depending on insulin therapy type.
Area of Science:
- Pediatric Endocrinology
- Immunology
- Metabolic Disorders
Background:
- Tumor necrosis factor-alpha (TNF-α) and its soluble form, sTNFR1, are key inflammatory mediators implicated in autoimmune diseases, insulin resistance, and metabolic dysregulation.
- These factors play a significant role in the pathogenesis of type 1 diabetes mellitus (DMT1) and its long-term complications.
Purpose of the Study:
- To evaluate TNF-α and sTNFR1 levels in children diagnosed with DMT1.
- To investigate the correlation of these markers with anthropometric data and metabolic control.
- To assess the influence of different insulin therapy regimens on TNF-α and sTNFR1 levels.
Main Methods:
- A study involving 67 children with DMT1 (aged 3.71–14.81 years) and 15 age-matched healthy controls.
- Patients were prepubertal and free of other diseases, with disease duration ranging from 1.83 to 9 years.
- Subgroup analysis based on insulin therapy type (pump, multiple injections, conventional) with no significant differences in metabolic control, age, weight, height, or BMI between groups.
Main Results:
- TNF-α levels were lower in the DMT1 group compared to controls (mean 1.62 ± 0.41 pg/ml vs. 1.67 ± 1.41 pg/ml, p >0.05), with the highest levels observed in the insulin pump group.
- sTNFR1 levels were higher in the DMT1 group (mean 1028.18 ± 181.24 pg/ml) than in controls (mean 978.00 ± 203.03 pg/ml, p >0.05), also showing the highest levels in the insulin pump group.
- TNF-α correlated only with height, while sTNFR1 correlated with anthropometric parameters; neither marker's levels were dependent on the type of insulin therapy.
Conclusions:
- TNF-α levels are reduced in children with DMT1 and correlate with height, independent of insulin therapy type.
- sTNFR1 levels are elevated in children with DMT1, correlate with anthropometric parameters, and are not influenced by the type of insulin therapy used.
Introduction:
TNF-α, and its soluble form sTNFR1, as proinflammatory hormone plays a great role in pathogenesis of auto immunological diseases, insulin resistance, both carbohydrates and fat metabolism and development of late complications in type 1 diabetes mellitus (DMT1) patients.
Aim Of The Study:
To asses TNF-α and sTNFR1 levels in children with DMT1 and to analyze the correlation with anthropometric parameters, metabolic control and the influence of the kind of insulin therapy.
Material And Methods:
67 patients, aged from 3.71 to 14.81 years (mean±SD: 10.33±2.21). All the children were prepubertal (T ≰2), suffering for DMT1, without any coexisting diseases. The duration of the disease varied from 1.83 to 9 years (mean±SD: 4,0±1,6), and the age at diagnosis oscillated between 1.84 to 10.81 years. All the patients were divided into subgroups according to the kind of therapy which was not changed in the last 6 months. 15 agematched healthy children were included into the study. There were no statistically significant differences between the groups as to the metabolic control, age, weight, height and BMI.
Results:
TNF-α levels in the study group ranged from 0.30 to 14.20 ng/ml (mean±1.62 ± 0.41 pg/ml) and were lower than in the control group: from 0.20 to 19.00 pg/ml (mean±SD: 1.67±1.41 pg/ml) (p >0.05). The highest TNF-α levels were observed in the insulin pump group, lower in the multiple insulin injection group and in the conventional insulin therapy group. The sTNFR1 in the study group ranged from 707.00 to 1646.00 pg/ml (mean±SD: 1028.18±181.24 pg/ml) and was higher than in the control group: 613.0 to 1310.00 pg/ml (mean±SD: 978.00±203.03 pg/ml) (p >0.05). The highest sTNFR1 levels were observed in the insulin pump group, lower in the multiple insulin injection group and the lowest in the conventional insulin therapy group.
Conclusions:
TNF-α levels are lower in DMT1 children, correlate only with height and do not depend on the kind of insulin therapy. sTNFR1 levels are higher in children with DMT1, correlate with anthropometric parameters and do not depend on the kind of insulin therapy.
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