Neubauer-Geryk Jolanta, Wielicka Melanie, Myśliwiec Małgorzata, Zorena Katarzyna, Bieniaszewski Leszek
Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdansk, Poland.
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Division of Neonatology, Ann Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.
Biomedicines. 2023 Oct 22;11(10):2857. doi: 10.3390/biomedicines11102857.
The aim of this study was to analyze the relationship between immunological markers and the dysfunction of cutaneous microcirculation in young patients with type 1 diabetes. The study group consisted of 46 young patients with type 1 diabetes and no associated complications. Microvascular function was assessed with the use of nail fold capillaroscopy before and after implementing post-occlusive reactive hyperemia. This evaluation was then repeated after 12 months. Patients were divided into two subgroups according to their baseline median coverage (defined as the ratio of capillary surface area to surface area of the image area), which was established during the initial exam (coverage). Additionally, the levels of several serum biomarkers, including VEGF, TNF-a and IL-35, were assessed at the time of the initial examination. HbA1c levels obtained at baseline and after a 12-month interval were also obtained. Mean HbA1c levels obtained during the first two years of the course of the disease were also analyzed. Patients with coverage below 16.85% were found to have higher levels of VEGF and TNF-α, as well as higher levels of HbA1c during the first two years following diabetes diagnosis. Our results support the hypothesis that the development of diabetic complications is strongly influenced by metabolic memory and an imbalance of pro- and anti-inflammatory cytokines, regardless of achieving adequate glycemic control.
本研究的目的是分析1型糖尿病年轻患者免疫标志物与皮肤微循环功能障碍之间的关系。研究组由46例无相关并发症的1型糖尿病年轻患者组成。在实施闭塞后反应性充血前后，使用甲襞毛细血管显微镜评估微血管功能。12个月后重复该评估。根据初始检查时确定的基线中位数覆盖率（定义为毛细血管表面积与图像区域表面积之比），将患者分为两个亚组（覆盖率）。此外，在初始检查时评估了几种血清生物标志物的水平，包括血管内皮生长因子（VEGF）、肿瘤坏死因子-α（TNF-α）和白细胞介素-35（IL-35）。还获得了基线时和间隔12个月后的糖化血红蛋白（HbA1c）水平。还分析了疾病病程头两年期间获得的平均HbA1c水平。发现覆盖率低于16.85%的患者在糖尿病诊断后的头两年中VEGF和TNF-α水平较高，HbA1c水平也较高。我们的结果支持以下假设：无论血糖控制是否充分，糖尿病并发症的发生都受到代谢记忆以及促炎和抗炎细胞因子失衡的强烈影响。
