Correlation between transforming growth factor-β1 (TGF- β1) with premature atherosclerosis in type 1 diabetes

Type 1 diabetes (T1D) carries a significant risk of atherosclerosis as the main driver for cardiovascular events. Atherosclerosis is initiated by the activation of the endothelium by various risk factors through the inflammation process. The anti-inflammatory cytokine TGF-β1 may inhibit the development of atherosclerosis.

In a cross-sectional study, a total of 40 patients aged 14.5±3.16 years old with T1D and 40 healthy controls aged 14.7±0.99 years old were involved. Common carotid artery IMT (cIMT) was measured by real-time M-echocardiography mode (Affinity 50G Philips) and Flow Mediated Dilatation (FMD), using high-resolution ultrasonography and Doppler flow characteristics. The TGF-β1 level was measured by indirect ELISA at Saiful Anwar Hospital Laboratory.

There were no differences in age, gender, Body Mass Index (BMI), duration of diabetes, renal function, or nutritional status between the T1D and healthy groups (p>0.05). A significant difference in cIMT was observed between the T1D group and the healthy group (0.567 ± 0.87 mm vs. 0.387 ± 0.57 mm, p = 0.000), FMD (7.17 ± 3.98 mm vs. 11.22 ± 5.48 mm, p = 0.000), and the level of TGF-β1 cytokine (39.83±13.51 vs. 73.67±15.34 pg/ml, p = 0.000). A significantly negative correlation between TGF-β1 and cIMT (p = 0.000; r = -0.685) and a significantly positive correlation between TGF-β1 and FMD (p = 0.000; r = +0.55) were found.

Atherosclerosis is an inflammatory disease accelerated by diabetes. The inflammation process is more prominent in T1D patients. T1D patients show a decreased level of TGF-β1, increased measurement of cIMT (>0.5 mm), and a decreased measurement of FMD.