Sallam Dina E, Elhenawy Yasmine Ibrahim Mahmoud, Ahmed Aya Mohamed Abdullah, Taha Sara Ibrahim Abdelfattah, Elsayed Eman Mohamed
Department of Pediatrics and Pediatric Nephrology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Department of Pediatric, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pediatr Nephrol. 2025 May 12. doi: 10.1007/s00467-025-06793-3.
Uncontrolled diabetes mellitus (DM) accelerates atherosclerosis and vascular diseases, leading to micro- and macrovascular complications. Early cardiac and kidney involvement necessitates an early biomarker. Sclerostin is a Wnt-signaling inhibitor, having a pathophysiological role in vasculopathy, and could be used as a vasculopathy marker. Nevertheless, few data are available in pediatric patients with type 1 diabetes mellitus (T1DM). We aimed at assessing its serum level, and relation to diabetic microvascular and macrovascular complications.
This is a case control study on patients with T1DM, and healthy controls. Patients were divided into non-diabetic nephropathy (DN), and DN groups according to proteinuria. Patients' clinicodemographic and anthropometrics were obtained, with withdrawal of fasting serum lipid profile, kidney function test, and serum sclerostin. Carotid intimal media thickness (CIMT), a marker of subclinical atherosclerosis, was measured.
We had 75 comparable subjects, where median (IQR) serum sclerostin levels were significantly higher in DN, compared to non-DN and controls [90.83 (82.32 - 115.1), vs. 33.29 (28.37 - 38.53), vs. 13.5 (10.32 - 15.72) ng/mL,respectively, p, < 0.001]. Similarly, median (IQR) CIMT was significantly higher in DN, than in non-DN and controls [1.1 (0.8 - 1.3), vs. 0.11 (0.1 - 0.2), vs. 0.11 (0.1 - 0.2) mm, respectively, p < 0.001]. Serum sclerostin level correlated positively with disease duration, higher HgbA1c%, albuminuria level, and CIMT in all patients. The cut-off values of serum sclerostin > 60.0 ng/mL and CIMT > 0.3 mm were able to detect DN.
Serum sclerostin levels may serve as a potential biomarker for microvascular and macrovascular complications in pediatric patients with T1DM.
未控制的糖尿病（DM）会加速动脉粥样硬化和血管疾病，导致微血管和大血管并发症。心脏和肾脏的早期受累需要早期生物标志物。硬化素是一种Wnt信号抑制剂，在血管病变中具有病理生理作用，可作为血管病变标志物。然而，关于1型糖尿病（T1DM）儿科患者的数据很少。我们旨在评估其血清水平及其与糖尿病微血管和大血管并发症的关系。
这是一项针对T1DM患者和健康对照的病例对照研究。根据蛋白尿情况将患者分为非糖尿病肾病（DN）组和糖尿病肾病组。获取患者的临床人口统计学和人体测量学数据，同时采集空腹血脂谱、肾功能测试结果及血清硬化素。测量颈动脉内膜中层厚度（CIMT），这是亚临床动脉粥样硬化的一个标志物。
我们有75名可比较的受试者，其中糖尿病肾病组血清硬化素水平的中位数（四分位间距）显著高于非糖尿病肾病组和对照组[分别为90.83（82.32 - 115.1）、33.29（28.37 - 38.53）和13.5（10.32 - 15.72）ng/mL，p < 0.001]。同样，糖尿病肾病组CIMT的中位数（四分位间距）显著高于非糖尿病肾病组和对照组[分别为1.1（0.8 - 1.3）、0.11（0.1 - 0.2）和0.11（0.1 - 0.2）mm，p < 0.001]。在所有患者中，血清硬化素水平与病程、较高的糖化血红蛋白百分比、蛋白尿水平及CIMT呈正相关。血清硬化素>60.0 ng/mL和CIMT > 0.3 mm的临界值能够检测出糖尿病肾病。
血清硬化素水平可能作为T1DM儿科患者微血管和大血管并发症的潜在生物标志物。
