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Published on: May 6, 2013
Inflammation in childhood type 1 diabetes; influence of glycemic control
Martin Heier1, Hanna Dis Margeirsdottir2, Cathrine Brunborg3
1Pediatric Department Ullevål, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; Oslo Diabetes Research Centre, Oslo, Norway.
Insights
Children with type 1 diabetes show increased inflammation markers linked to hyperglycemia, suggesting a key role in early atherosclerosis development. This highlights the impact of blood sugar control on cardiovascular health in pediatric diabetes.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Research
- Immunology
Background:
- Type 1 diabetes (T1D) is associated with elevated cardiovascular disease mortality.
- Inflammation is a critical factor in the pathogenesis of atherosclerosis.
- Early detection and management of atherosclerosis risk factors in children with T1D are crucial.
Purpose of the Study:
- To investigate the extent of inflammation in children with T1D.
- To assess the influence of glycemic control on early atherosclerosis markers.
- To compare inflammation profiles in T1D patients versus healthy controls.
Main Methods:
- A population-based cohort study in Norway included 314 children with T1D and 120 healthy controls (aged 8-18 years).
- Circulating levels of key inflammatory markers (VCAM-1, ICAM-1, E-selectin, P-selectin, TNFα, IL-6, CRP, MCP-1, IL-18, MMP-9, TIMP-1) were measured.
- Immunoassays were utilized for precise quantification of these biomarkers.
Main Results:
- T1D patients exhibited significantly higher levels of most measured inflammatory markers compared to controls.
- In T1D patients, most markers correlated significantly with HbA1c, indicating a link to glycemic control.
- C-reactive protein (CRP) showed the most significant difference and strongest correlation with HbA1c; oral contraceptive use elevated CRP independently of diabetes.
Conclusions:
- Inflammation plays a significant role in accelerated atherosclerosis in early-stage T1D.
- Hyperglycemia appears to be the primary driver of this inflammation-associated process.
- These findings underscore the importance of managing blood glucose levels to mitigate cardiovascular risk in pediatric T1D.
Objective:
Patients with type 1 diabetes have increased mortality from cardiovascular disease, and inflammation is important in the development of atherosclerosis. Our aim was to evaluate the extent of inflammation and the influence of glycemic control in the early phases of atherosclerosis in childhood type 1 diabetes.
Materials And Methods:
A population based cohort representative of all children with type 1 diabetes in Norway was studied. Diabetes patients (n = 314) were compared to healthy controls (n = 120), aged 8-18 years. Circulating levels of VCAM-1, ICAM-1, E-selectin, P-selectin, TNFα, IL-6, CRP, MCP-1, IL-18, MMP-9 and TIMP-1 were measured by immunoassays.
Results:
The diabetes patients had a mean age of 13.7 (SD = 2.8) years, disease duration of 5.5 (SD = 3.4) years and HbA1c of 8.4 (SD = 1.2) % (68 mmol/mol, SD = 13.1). The levels of most of the measured markers were significantly increased in the diabetes group compared to controls. In the diabetes group, all except MCP-1 and MMP-9 were significantly correlated to HbA1c, albeit the relation to VCAM-1 was inverse. There were no significant correlations in the control group. The measured markers were only to a limited degree associated with traditional risk factors. CRP showed the most pronounced difference between diabetes patients and controls and the strongest correlation with HbA1c. The use of oral contraceptives profoundly increased CRP levels, independent of the presence of diabetes.
Conclusions:
Our results indicate that inflammation may play an important role in the accelerated atherosclerosis in early type 1 diabetes, and that this process seems primarily driven by hyperglycemia.
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