Department of Clinical and Experimental Endocrinology, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Poland.
Hum Immunol. 2013 Jan;74(1):75-81. doi: 10.1016/j.humimm.2012.10.002. Epub 2012 Oct 13.
The aim of this study was to estimate the threshold serum concentrations of advanced glycation end products (AGEs) and their soluble receptors (sRAGE) as well as tumour necrosis factor alpha (TNFα), vascular endothelial growth factor(165) (VEGF(165)) and interleukin-12 (IL-12) in predicting the occurrence of microangiopathy in children and adolescents with type 1 diabetes mellitus (T1DM). We studied 88 children and adolescents (age range: 6-20 yrs) with T1DM and 32 control subjects (age range: 7-20 yrs). All study participants had their daily urinary albumin excretion, HbA1c and serum creatinine levels measured, and underwent an eye examination and 24-h blood pressure monitoring. Moreover, serum concentrations of AGEs, sRAGE, TNFα, VEGF(165) and IL-12 were measured. In order to calculate the threshold values of the studied parameters, the Receiver Operating Characteristic (ROC) curve analysis was used. The results of our study have shown that among all the studied parameters a discriminative ability was found for TNFα, VEGF(165), duration of the disease, serum AGEs concentrations and daily urinary albumin excretion. However, the highest value of the area under the ROC curve (AUC(ROC)) in predicting the occurrence of diabetic microangiopathy was found for serum TNFα concentrations with its threshold value of 1.7 pg/ml [AUC(ROC) = 0.88 (95% CI: 0.79-0.97)]. The sensitivity and specificity for this variable was at the level of 85.7% and 94.3%, respectively. In conclusion, according to our results serum TNFα concentrations over 1.7 pg/ml may point to the presence of diabetic microangiopathy in children and adolescents T1DM.
本研究旨在评估晚期糖基化终产物（AGEs）及其可溶性受体（sRAGE）、肿瘤坏死因子-α（TNFα）、血管内皮生长因子 165（VEGF165）和白细胞介素-12（IL-12）的血清浓度阈值，以预测 1 型糖尿病（T1DM）患儿和青少年微血管并发症的发生。我们研究了 88 名 T1DM 患儿和青少年（年龄范围：6-20 岁）和 32 名对照组（年龄范围：7-20 岁）。所有研究参与者均测量了其每日尿白蛋白排泄量、糖化血红蛋白（HbA1c）和血清肌酐水平，并进行了眼部检查和 24 小时血压监测。此外，还测量了血清 AGEs、sRAGE、TNFα、VEGF165 和 IL-12 的浓度。为了计算研究参数的阈值值，我们使用了接收器工作特征（ROC）曲线分析。我们的研究结果表明，在所研究的参数中，TNFα、VEGF165、疾病持续时间、血清 AGEs 浓度和每日尿白蛋白排泄量具有鉴别能力。然而，在预测糖尿病微血管并发症发生方面，ROC 曲线下面积（AUC(ROC)）最高的是血清 TNFα浓度，其阈值为 1.7 pg/ml[AUC(ROC) = 0.88（95%CI：0.79-0.97)]。该变量的敏感性和特异性分别为 85.7%和 94.3%。总之，根据我们的结果，血清 TNFα 浓度超过 1.7 pg/ml 可能表明 T1DM 患儿和青少年存在糖尿病微血管并发症。
