HbA1c levels and circulating inflammatory proteins at onset of type 1 diabetes in children and adolescents

Abstract

Purpose Type 1 diabetes is an autoimmune disease that often develops during childhood. Complications such as retinopathy often occur during the course of the disease. Studies to identify possible predictors of complications in type 1 diabetes are needed; in particular markers able to identify risk of complications long before they occur. The first aim of this study was to investigate plasma levels of sCD163, sST2 and Gal-3 at diagnosis of type 1 diabetes in children and adolescents. The second aim was to study their correlation to HbA1c in this study cohort. Methods Patients (n = 242, 0–18 years) with type 1 diabetes, at Helsingborg’s Hospital were included in this study and circulating levels of sCD163, sST2 and Gal-3 were investigated in plasma using commercially available DuoSet ELISA and supplementary ancillary kit. Results Circulating sCD163 was significantly higher at diagnosis compared to after diagnosis (666 ± 318ng/ml and 505 ± 223ng/ml respectively; p < 0.001). Also sST2 was significantly higher (18.2 [12.7–25.6] ng/ml respectively 9.1 [6.3–13.5] ng/ml (p < 0.001), but Gal-3 levels did not differ from onset of diabetes to after diagnosis. HbA1c was shown to correlate to sCD163 (rs=0.36; p < 0.001), sST2 (rs=0.22; p = 0.016) and Gal-3 (rs=0.2; p = 0.020) in patients with a diabetes duration < 5 years. Conclusions sCD163 levels increased in patients with recent-onset type 1 diabetes and the levels increased with higher HbA1c. Patients included in this study will be followed annually until the eventual development of diabetic complications, while continuously studying circulating levels of inflammatory proteins such as sCD163.

Cystatin C as an adjunct to HbA1c may prove useful in predicting the development of diabetic complications in children and adolescents with type 1 diabetes

“…As previously mentioned, studies have shown an association with circulating proteins for vascular disease in both children and adults with type 1 diabetes [ 26 – 29 ]. In our own previous study we found sCD163 levels increased in patients with recent-onset type 1 diabetes and the levels increased with higher HbA1c [ 30 ].…”