Startseite Medizin Glycemic variability predicts inflammation in adolescents with type 1 diabetes
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Glycemic variability predicts inflammation in adolescents with type 1 diabetes

  • Robert P. Hoffman EMAIL logo , Amanda S. Dye , Hong Huang und John A. Bauer
Veröffentlicht/Copyright: 22. September 2016
Journal of Pediatric Endocrinology and Metabolism
Aus der Zeitschrift Journal of Pediatric Endocrinology and Metabolism Band 29 Heft 10

Abstract

Background:

Adolescents with type 1 diabetes (T1D) have increased risk of cardiovascular disease as well as elevations in biomarkers of systemic inflammation, plasma protein oxidation and vascular endothelial injury. It is unclear whether hyperglycemia itself, or variations in blood glucose are predictors of these abnormalities.

Methods:

This study was designed to determine the relationship of inflammatory (C-reactive protein, CRP), oxidative (total anti-oxidative capacity, TAOC) and endothelial injury (soluble intracellular adhesion molecule 1, sICAM1) markers to glycemic control measures from 3 days of continuous glucose monitoring (CGM) and to hemoglobin A1c (HbA1c), and HbA1c×duration area under the curve (A1cDur).

Results:

Seventeen adolescents (8 F/9M; age, 13.1±1.6 years (mean±SD); duration, 4.8±3.8 years, BMI, 20.3±3.1 kg/m2; A1c, 8.3±1.2%) were studied. Log CRP but was not related to age, duration, body mass index (BMI), HbA1c, or A1cDUR. TAOC increased as logA1cDUR increased (n=13, r=0.61, p=0.028). CRP and sICAM were not related to CGM average glucose but log CRP increased as 3 day glucose standard deviation increased (r=0.66, p=0.006). TAOC increased as glucose standard deviation increased (r=0.63, p=0.028).

Conclusions:

Increased glucose variability is associated with increased inflammation in adolescents withT1D. Increased TAOC with increasing variability may be an effort to compensate for the ongoing oxidative stress.

Keywords: glucose variability; inflammation; type 1 diabetes; vascular endothelial injury/stress; oxidation
Corresponding author: Robert P. Hoffman, MD, Department of Pediatrics, The Ohio State University, The Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, ED422, Columbus, OH 43205, USA, Phone: +614-722-4425, Fax: +614-722-4440

Acknowledgments

The authors thank Karen Carter, Lauren Bird, and Jesse Haines (Research Institute at Nationwide Children’s Hospital) for their help with recruiting subjects and performing the research and the nurses of the CRC for their help with the blood drawing.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. RH wrote protocol and obtained research funding, supervised or directly collected data, wrote and edited the manuscript. He is responsible for its content. AD participated in data collection and reviewed the manuscript. HH performed laboratory measurement and reviewed the manuscript. JB supervised laboratory measurements and reviewed and edited manuscript. Dr. Robert Hoffman is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  2. Research funding: This study was supported by the National Institutes of Health NIDDK grant R21DK083642-01 and the American Reinvestment and Recovery Act of 2009. The project described was, also, supported by Award Number UL1RR025755 from the National Center for Research Resources. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. The authors have no conflicts of interest related to this manuscript.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2016-4-12
Accepted: 2016-8-1
Published Online: 2016-9-22
Published in Print: 2016-10-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. An update on thyroid-associated ophthalmopathy in children and adolescents
  4. Mini Review
  5. Systematic review and meta-analysis of the association between mumps during childhood and risk of type 1 diabetes mellitus
  6. Original Articles
  7. Glycemic variability predicts inflammation in adolescents with type 1 diabetes
  8. Prevalence and risk factors for diabetic retinopathy in a hospital-based population of Australian children and adolescents with type 1 diabetes
  9. One month of omega-3 fatty acid supplementation improves lipid profiles, glucose levels and blood pressure in overweight schoolchildren with metabolic syndrome
  10. The outcome of seven patients with hereditary tyrosinemia type 1
  11. Increased oxidative stress parameters in children with moderate iodine deficiency
  12. Relationship between 25(OH)D levels and circulating lipids in African American adolescents
  13. Endoglin and obestatin levels, cardiometabolic risk factors and subclinical atherosclerosis in children aged 10–18 years
  14. Lipoprotein-associated phospholipase A2 activity and low-density lipoprotein subfractions after a 2-year treatment with atorvastatin in adolescents with type 1 diabetes
  15. Genetic characteristics and long-term follow-up of 11 patients with congenital hyperinsulinism followed in a single center
  16. Pituitary volume in children with growth hormone deficiency, idiopathic short stature and controls
  17. Case Reports
  18. A novel insulin receptor mutation in an adolescent with acanthosis nigricans and hyperandrogenism
  19. Primary hyperparathyroidism may masquerade as rickets-osteomalacia in vitamin D replete children
  20. Co-existence of phenylketonuria either with maple syrup urine disease or Sandhoff disease in two patients from Iran: emphasizing the role of consanguinity
  21. Severe malnutrition causing superior mesenteric artery syndrome in an adolescent with Triple A syndrome
  22. Solving a case of allelic dropout in the GNPTAB gene: implications in the molecular diagnosis of mucolipidosis type III alpha/beta
https://doi.org/10.1515/jpem-2016-0139
Schlagwörter für diesen Artikel
glucose variability; inflammation; type 1 diabetes; vascular endothelial injury/stress; oxidation

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. An update on thyroid-associated ophthalmopathy in children and adolescents
  4. Mini Review
  5. Systematic review and meta-analysis of the association between mumps during childhood and risk of type 1 diabetes mellitus
  6. Original Articles
  7. Glycemic variability predicts inflammation in adolescents with type 1 diabetes
  8. Prevalence and risk factors for diabetic retinopathy in a hospital-based population of Australian children and adolescents with type 1 diabetes
  9. One month of omega-3 fatty acid supplementation improves lipid profiles, glucose levels and blood pressure in overweight schoolchildren with metabolic syndrome
  10. The outcome of seven patients with hereditary tyrosinemia type 1
  11. Increased oxidative stress parameters in children with moderate iodine deficiency
  12. Relationship between 25(OH)D levels and circulating lipids in African American adolescents
  13. Endoglin and obestatin levels, cardiometabolic risk factors and subclinical atherosclerosis in children aged 10–18 years
  14. Lipoprotein-associated phospholipase A2 activity and low-density lipoprotein subfractions after a 2-year treatment with atorvastatin in adolescents with type 1 diabetes
  15. Genetic characteristics and long-term follow-up of 11 patients with congenital hyperinsulinism followed in a single center
  16. Pituitary volume in children with growth hormone deficiency, idiopathic short stature and controls
  17. Case Reports
  18. A novel insulin receptor mutation in an adolescent with acanthosis nigricans and hyperandrogenism
  19. Primary hyperparathyroidism may masquerade as rickets-osteomalacia in vitamin D replete children
  20. Co-existence of phenylketonuria either with maple syrup urine disease or Sandhoff disease in two patients from Iran: emphasizing the role of consanguinity
  21. Severe malnutrition causing superior mesenteric artery syndrome in an adolescent with Triple A syndrome
  22. Solving a case of allelic dropout in the GNPTAB gene: implications in the molecular diagnosis of mucolipidosis type III alpha/beta
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