SERUM LEVELS OF TUMOR NECROSIS FACTOR ALPHA (TNF-α) IN TYPE 1 DIABETIC CHILDREN AS APREDICTOR OF METABOLIC CONTROL

Abd El-Monem Mattar, Mohammed; Mohammed El-Masry, Hosny; Abd El-Azeem Hassan, Mostafa; Mohammed Hassan, Abd El-Monem; Abbas Metwally, Kotb; Sayed  Allam, Mohammed

doi:10.21608/azjp.2015.99842

SERUM LEVELS OF TUMOR NECROSIS FACTOR ALPHA (TNF-α) IN TYPE 1 DIABETIC CHILDREN AS APREDICTOR OF METABOLIC CONTROL

Document Type : Original Article

Authors

10.21608/azjp.2015.99842

Abstract

Background: Type 1 diabetes mellitus (T1DM) is the most common metabolic disease in childhood. In the course of diabetes, the main clinical problem to be faced is the development of micro- and macro-angiopathies. It has been suggested that hyperglycemia may lead to the activation of proinflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-12 (IL-12)]that are crucial for development and progression of microangiopathy. TNF-α production is thought to play a role in the generation of microvascular complications associated with diabetes. In addition to triggering acute and chronic inflammation, TNF-α regulates glucose and lipid metabolism and inhibits insulin production in pancreatic beta cells.
Aim of the study: To estimate the tumor necrosis factor alpha (TNF-α) levels as one of immunologic markers of microangiopathies in children with type 1 DM.
and the correlation of its level with other inflammatory markers as CRP and ESR as well as with other important factors as microalbuminuria and Glycosylated hemo-globin (Hb A1c).
Patients and methods: The study was a cross-sectional study included 60 children with T1DM recruited from the regular attendants of the Diabetes Clinic, Children's Hospital, Assiut University. They were 28 males (46.7%) and 32 females (53.3%), Their ages ranged between 1-16 years with a mean ± SD 9.46 ± 4.09 years. T1DM, was defined in accordance with the criteria of the American Diabetes Association (ADA 2007) All patients were on regular insulin treatment in dose of (0.99 ± 0.28 unit/kg/day).The control group consisted of 20 apparently healthy children of matched age, sex and nutritional status.
Results: Our results demonstrated that; there were significant differences between type 1 diabetic patients with normal and abnormal TNF-α regarding mean levels of blood urea , serum lipid profile (total cholesterol, triglycerides , LDL & HDL ) , HbA1c concentrations and mean levels of inflammatory markers and microalbuminuria. While, there was no significant difference regarding CBC and serum creatinine between both groups. Also there was a significant difference between diabetic patients with abnormal TNF group and diabetic patients with normal TNF group regarding weight and body mass index (BMI). While there was no significant difference between both groups regarding age, height, systolic as well as diastolic blood pressure measurements, duration of diabetes and insulin dose.