Sabry Rania N, El Wakeel Maged A, El-Kassas Ghada M, Amer Ahmed F, El Batal Wael H, El-Zayat Salwa Refat, Abou-El-Asrar Mohamed
Department of Child Health, National Research Centre, Cairo, Egypt.
Department of Medical Physiology, National Research Centre, Cairo, Egypt.
Open Access Maced J Med Sci. 2018 Apr 4;6(4):613-617. doi: 10.3889/oamjms.2018.144. eCollection 2018 Apr 15.
Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in children that may be complicated by micro or macrovascular complications. Measurement of the carotid intima-media thickness (CIMT) allows the early detection of atherosclerotic alterations of blood vessels that may complicate T1DM.
This study is a case-control study. Participants were classified into two groups. The first group included 40 children with T1DM and the second group included 30 matched healthy controls. The studied cases were recruited from Endocrinology and Diabetology Unit, Pediatric Hospital, Ain Shams University. Serum apelin, cholesterol, TG, LDL were measured for every case. Also, albumin level was analyzed in urine. Measurement of the carotid intima-media thickness (CIMT) was done for all cases.
Comparison between T1DM patients and controls revealed that serum apelin, cholesterol, TG, LDL and albuminuria were significantly increased in cases compared to controls. Significant positive correlations were detected between HbA1C, albuminuria and lipid profile with apelin in the diabetic group (p < 0.05). CIMT has significant positive correlation with serum apelin levels (r = 0.36, p = 0.05). Also, this study found positive correlations between CIMT and some variables as LDL, SBP z-score and duration of the illness.
Increased levels of serum apelin in T1DM patients may be considered as predicting factor for the ongoing development of vascular sequels. This study highlighted the possible validity of apelin assay as an early predictor of atherosclerosis in T1DM children. Evaluating CIMT in these patients is of at most important for early detection of subclinical atherosclerosis.
1型糖尿病（T1DM）是儿童中最常见的慢性病之一，可能并发微血管或大血管并发症。测量颈动脉内膜中层厚度（CIMT）有助于早期发现可能使T1DM复杂化的血管动脉粥样硬化改变。
本研究为病例对照研究。参与者分为两组。第一组包括40名T1DM儿童，第二组包括30名匹配的健康对照。研究病例来自艾因夏姆斯大学儿童医院内分泌与糖尿病科。对每个病例测量血清apelin、胆固醇、甘油三酯、低密度脂蛋白。同时，分析尿中白蛋白水平。对所有病例进行颈动脉内膜中层厚度（CIMT）测量。
T1DM患者与对照组比较显示，病例组血清apelin、胆固醇、甘油三酯、低密度脂蛋白和蛋白尿均显著高于对照组。糖尿病组中，糖化血红蛋白、蛋白尿和血脂谱与apelin之间存在显著正相关（p < 0.05）。CIMT与血清apelin水平呈显著正相关（r = 0.36，p = 小05）。此外，本研究还发现CIMT与一些变量如低密度脂蛋白、收缩压z评分和病程之间存在正相关。
T1DM患者血清apelin水平升高可能被视为血管后遗症持续发展的预测因素。本研究强调了apelin检测作为T1DM儿童动脉粥样硬化早期预测指标的可能有效性。评估这些患者的CIMT对于亚临床动脉粥样硬化的早期检测至关重要。
