Section of Pediatric Endocrinology, Georgia Regents University (formerly Georgia Health Sciences University), Augusta, Georgia, United States of America.
PLoS One. 2013 Aug 27;8(8):e71905. doi: 10.1371/journal.pone.0071905. eCollection 2013.
Diastolic dysfunction suggestive of diabetic cardiomyopathy is established in children with T1DM, but its pathogenesis is not well understood. We studied the relationships of systemic inflammatory cytokines/chemokines and cardiac function in 17 children with T1DM during and after correction of diabetic ketoacidosis (DKA). Twenty seven of the 39 measured cytokines/chemokines were elevated at 6-12 hours into treatment of DKA compared to values after DKA resolution. Eight patients displayed at least one parameter of diastolic abnormality (DA) during acute DKA. Significant associations were present between nine of the cytokine/chemokine levels and the DA over time. Interestingly, four of these nine interactive cytokines (GM-CSF, G-CSF, IL-12p40, IL-17) are associated with a Th17 mediated cell response. Both the DA and CCL7 and IL-12p40, had independent associations with African American patients. Thus, we report occurrence of a systemic inflammatory response and the presence of cardiac diastolic dysfunction in a subset of young T1DM patients during acute DKA.
在患有 1 型糖尿病的儿童中已经确立了舒张功能障碍提示糖尿病心肌病，但发病机制尚不清楚。我们研究了在纠正糖尿病酮症酸中毒（DKA）期间和之后的 17 名患有 1 型糖尿病的儿童中全身炎症细胞因子/趋化因子与心功能的关系。与 DKA 缓解后的数值相比，在 DKA 治疗的 6-12 小时期间，有 27 种细胞因子/趋化因子升高。在急性 DKA 期间，有 8 名患者至少有一个舒张异常（DA）参数。随着时间的推移，9 种细胞因子/趋化因子水平与 DA 之间存在显著关联。有趣的是，这 9 种相互作用的细胞因子中的 4 种（GM-CSF、G-CSF、IL-12p40、IL-17）与 Th17 介导的细胞反应有关。DA 和 CCL7 以及 IL-12p40 与非裔美国患者均有独立关联。因此，我们报告了在急性 DKA 期间，年轻的 1 型糖尿病患者中出现全身炎症反应和心脏舒张功能障碍的情况。
