Redondo M J, Rodriguez L M, Haymond M W, Hampe C S, Smith E O, Balasubramanyam A, Devaraj S
Department of Pediatrics, Section of Diabetes and Endocrinology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Pediatr Diabetes. 2014 Dec;15(8):543-9. doi: 10.1111/pedi.12159. Epub 2014 Jun 30.
BACKGROUND/OBJECTIVE: Obesity increases the risk of cardiovascular disease and diabetic complications in type 1 diabetes. Adipokines, which regulate obesity-induced inflammation, may contribute to this association. We compared serum adipokines and inflammatory cytokines in obese and lean children with new-onset autoimmune type 1 diabetes.
We prospectively studied 32 lean and 18 obese children (age range: 2-18 yr) with new-onset autoimmune type 1 diabetes and followed them for up to 2 yr. Serum adipokines [leptin, total and high molecular weight (HMW) adiponectin, omentin, resistin, chemerin, visfatin], cytokines [interferon (IFN)-gamma, interleukin (IL)-10, IL-12, IL-6, IL-8, and tumor necrosis factor (TNF)-alpha] and C-reactive protein (CRP) were measured at a median of 7 wk after diagnosis (range: 3-16 wk).
Lean children were 71.9% non-Hispanic White, 21.9% Hispanic, and 6.3% African-American, compared with 27.8, 55.6, and 16.7%, respectively, for obese children (p = 0.01). Compared with lean children, obese children had significantly higher serum leptin, visfatin, chemerin, TNF-alpha and CRP, and lower total adiponectin and omentin after adjustment for race/ethnicity and Tanner stage. African-American race was independently associated with higher leptin among youth ≥10 yr (p = 0.007). Leptin levels at onset positively correlated with hemoglobin A1c after 1-2 yr (p = 0.0001) independently of body mass index, race/ethnicity, and diabetes duration. Higher TNF-alpha was associated with obesity and female gender, after adjustment for race/ethnicity (p = 0.0003).
Obese children with new-onset autoimmune type 1 diabetes have a proinflammatory profile of circulating adipokines and cytokines that may contribute to the development of cardiovascular disease and diabetic complications.
背景/目的：肥胖会增加1型糖尿病患者患心血管疾病和糖尿病并发症的风险。调节肥胖诱导炎症的脂肪因子可能与这种关联有关。我们比较了新发自身免疫性1型糖尿病肥胖儿童和瘦儿童的血清脂肪因子和炎性细胞因子。
我们前瞻性研究了32名瘦儿童和18名肥胖儿童（年龄范围：2 - 18岁），他们患有新发自身免疫性1型糖尿病，并对其随访长达2年。在诊断后中位数7周（范围：3 - 16周）时测量血清脂肪因子[瘦素、总脂联素和高分子量（HMW）脂联素、网膜素、抵抗素、趋化素、内脂素]、细胞因子[干扰素（IFN）-γ、白细胞介素（IL）-10、IL-12、IL-6、IL-8和肿瘤坏死因子（TNF）-α]以及C反应蛋白（CRP）。
瘦儿童中71.9%为非西班牙裔白人，21.9%为西班牙裔，6.3%为非裔美国人，而肥胖儿童分别为27.8%、55.6%和16.7%（p = 0.01）。在对种族/族裔和坦纳分期进行调整后，与瘦儿童相比，肥胖儿童的血清瘦素、内脂素、趋化素、TNF-α和CRP显著更高，而总脂联素和网膜素更低。非裔美国人种族与10岁及以上青少年的瘦素水平较高独立相关（p = 0.007）。发病时的瘦素水平在1 - 2年后与糖化血红蛋白呈正相关（p = 0.0001），独立于体重指数、种族/族裔和糖尿病病程。在对种族/族裔进行调整后，较高的TNF-α与肥胖和女性性别相关（p = 0.0003）。
新发自身免疫性1型糖尿病的肥胖儿童具有循环脂肪因子和细胞因子的促炎特征，这可能有助于心血管疾病和糖尿病并发症的发生发展。
