The tumour necrosis factor (TNF)-α system is activated in accordance with pulse pressure in normotensive subjects with type 1 diabetes mellitus

Abstract

Objective: Pulse pressure (PP) and inflammation are important predictors of cardiovascular disease (CVD), even in the normotensive. The age-related increase in PP can be diagnosed up to 20 years earlier in subjects with type 1 diabetes mellitus (T1DM) than in the general population. Some evidence suggests that PP can stimulate inflammation. Our aim was to study the relationship between PP and plasma inflammatory proteins in normotensive subjects with T1DM. Design: This was a cross-sectional study of a group of normotensive (,140/80 mmHg) subjects diagnosed with T1DM 14 years before. None of them had clinically proven CVD or inflammatory conditions or were on antiplatelet, antihypertensive, anti-inflammatory or lipid-lowering treatment. Methods: The following information was recorded: sex, age, body-mass index (BMI), waist-to-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), PP, mean blood pressure (MBP), smoking, alcohol intake, insulin dose, lipid profile, HbA1c, microvascular complications, and plasma concentrations of soluble receptor types 1 and 2 of tumour necrosis factor (TNF)-a (sTNFR1 and sTNFR2, respectively), interleukin-6, C-reactive protein, adiponectin and leptin. Results: A total of 112 subjects were evaluated (aged 27.4^6.6 years, 52.7% women, BMI: 20.4^2.7 kg/m 2 , WHR: 0.82^0.09, SBP: 112^12 mmHg, DBP: 68^9 mmHg, PP: 45^9 mmHg, MBP: 82^9 mmHg, HbA1c: 8.2% (7.3-9.0%), 41.1% microvascular complications). After adjusting for potential confounders, only inflammatory markers of the TNF-a system correlated significantly with PP (Pearson correlation coefficient between sTNFR1 and PP: r ¼ 0.215, P ¼ 0.030; and between PP and sTNFR2: r ¼ 0.238, P ¼ 0.020). Conclusion: In normotensive subjects with T1DM after 14 years of diagnosis, the activation of the TNF-a system is positively associated with PP levels. This finding might suggest a pathogenic role of the TNF-a system in the development of cardiovascular disease in T1DM.European Journal of Endocrinology 153 687-691

Low Serum Adiponectin Levels in Children and Adolescents with Diabetic Retinopathy

“…We also did not find a correlation between adiponectin and TNF-α or IL-6 levels. Although many studies have described a role of TNF-α and IL-6 in insulin resistance, disturbed glucose tolerance and microangiopathy [9,[25][26][27][28][29], we were also unable to show such a relationship in our patients who had developed complications. Similar to our findings, studies have shown that serum leptin levels increase with BMI, female sex, puberty and diabetic nephropathy but do not differ between type I DM patients and healthy controls [16,[30][31][32][33].…”

Impact of Simultaneous Pancreas and Kidney Transplantation on Cardiovascular Risk Factors in Patients With Type 1 Diabetes Mellitus

“…In type 1 DM patients, increased PP can be detected early and is associated with CVD (18,19). Recently, one study showed that in type 1 DM patients, the PP level was positively associated with activation of the tumor necrosis factor-␣ system, a marker of systemic inflammation (20). Thus, improvement in PP suggests a potential antiinflammatory role of pancreas transplant and is consistent with the findings of improved endothelial function observed in SPK patients (8).…”

Type 1 diabetes: Developing the first risk-estimation model for predicting silent myocardial ischemia. The potential role of insulin resistance

“…Peripheral polyneuropathy was assessed through a previously described two-step protocol combining the 15–item MNSI (Michigan Neuropathy Screening Instrument) questionnaire and a physical examination [28]. Retinopathy was always evaluated by the same ophthalmologist.…”