Early functional and metabolic disorders in children with type I diabetes mellitus and diabetic nephropathy

Burlaka, Ievgeniia; Maidannyk, V G

doi:10.5114/pedm.2021.107720

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…We speculate that cluster I in the T1D group, characterized by somewhat of an increase in PLT, hyperfiltration and reduced anti-apoptotic defense should be considered as a potential risk group for further complications, including DN and cardiovascular events. Previously, we have shown that children with T1D have increased GFR ( 28 ). This finding is in line with other research showing that a 25-50% elevation in the GFR is seen early in the course in up to one-half of patients with T1D, an abnormality that is exaggerated after ingestion of a protein load.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Apoptotic, Clinical, and Laboratory Parameters in Type 1 Diabetes and Early Diabetic Nephropathy: Clustering and Potential Groups Evaluation for Additional Therapeutic Interventions

Ie.a.¹

2022

Jcrpe

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Objective: Type 1 diabetes (T1D) is one of the most prevalent chronic illnesses diagnosed in childhood. Diabetic nephropathy (DN) is one of the commonest complication of T1D. Therefore the development of specific treatment that arrests progression of DN based on an individual approach would be beneficial. Analysis of criteria of apoptosis, and clinical, and laboratory characteristics in T1D and early DN in the framework of clustering may be helpful in the identification of potential groups for additional therapeutic interventions. Methods: A survey of 104 children (62 males, 42 females) with T1D and DN aged 2 to 17 years in the Endocrinology unit of Clinical Pediatric Hospital No 6 (Kyiv, Ukraine) was performed. Clinical data (age, gender, disease duration, blood pressure), conventional laboratory markers including complete blood count, serum cholesterol, hemoglobin A1c (Hb1Ac), glomerular filtration rate (GFR), and microalbuminurea (MAU), and markers of apoptosis (BcL-xL, caspase-3) and transcriptional factor HIF-1alfa were analyzed. Results: A cluster group in T1D children was characterized by somewhat higher number of platelets (PLT) - 344.9±7.88·10 9 /L, increased GFR up to hyperfiltration level 124.5±8.86 mL/min/1.73 m 2 and decreased anti-apoptotic defense - BcL-xL 144.9±2.35 a.u. was identified. Children with DN may be divided into three groups based on age, body mass index, systolic blood pressure, PLT count, erthyrocyte sedimentation rate, albumin/globulin ratio, serum cholesterol, Hb1Ac, number of diabetic ketoacidosis (DKA) episodes, GFR, MAU, HIF-1alfa, Bcl-xL, caspase-3 levels. Among children with early DN a cluster characterized by the following parameters was found: PLT count - 311.±12.05·10 9 /L, frequency of DKA episodes - 4.82±0.26 episodes/year, MAU - 112.0±10.12 mm/24 h, HIF - 200.5±3.49 a.u., BcL-xL - 128.8±3.1 a.u., and caspase-3 - 159.6±5.5 a.u. Conclusion: Thus, we hypothesize that T1D pediatric patients with increased PLT count, hyperfiltration and reduced anti-apoptotic defense may represent a group for additional therapeutic interventions, such as antioxidants along with stndard therapies to achieve optimal glycemic control. Within the DN group there was a sub-group with somewhat increased PLT count, high frequency of DKA episodes/year, high MAU, prominent increase in HIF level, prominent disturbances in apoptosis controlling factors BcL-xL and caspase-3 tht may require additional therapeutic interventions, again including antioxidants, but may additionally benefit from anti-apoptotic effectors along with optimal glycemic control, and management of hypertension and albuminuria.

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Section: Discussionmentioning

confidence: 99%

Analysis of Apoptotic, Clinical, and Laboratory Parameters in Type 1 Diabetes and Early Diabetic Nephropathy: Clustering and Potential Groups Evaluation for Additional Therapeutic Interventions

Ie.a.¹

2022

Jcrpe

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“…However, ET‐1 levels were shown to be considerably greater in T1D patients than in healthy children in research by Burlaka Ievgeniia et al on children with T1D and DKD during a 6‐year period. ET‐1 levels were higher in the DKD group compared to the T1D group and were positively correlated with disease duration in children with DKD (Burlaka & Maidannyk, 2021). However, the most recent study, which excluded patients with other forms of diabetes and employed T1D patients and healthy people as controls for each other, discovered that ET‐1 appeared to be lower in the T1D group compared to the control group (Alkaabi et al, 2011).…”

Section: Correlation Of Et‐1 Levels With Dkdmentioning

confidence: 99%

Research progress on the role of ET‐1 in diabetic kidney disease

Zhang

Liu

et al. 2023

Journal Cellular Physiology

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Diabetic kidney disease (DKD) is one of the common complications of diabetes mellitus, which usually progresses to end-stage renal disease and causes great damage to the health of patients. Endothelin-1 (ET-1), a molecule closely associated with the progression of DKD, has increased expression in response to high glucose stimulation and is involved in hemodynamic changes, inflammation, glomerular and tubular dysfunction in the kidney, causing an increase in proteinuria and a decrease in glomerular filtration function, ultimately leading to glomerulosclerosis and renal failure. This paper aims to review the molecular level changes, regulatory mechanisms, and mechanisms of action of ET-1 under DKD, clinical trials of ET-1 receptor antagonists in recent years and current problems, to provide basic information and new research directions and ideas for the treatment of DKD and ET-1-related research.

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“…Interestingly, a group of children with diabetic nephropathy and coexisting type 1 diabetes participating in the Burlaka and Maidannyk study showed higher blood cholesterol levels and higher systolic and diastolic blood pressure values than children with type 1 diabetes without signs of nephropathy. Consequently, lipid disorders may be one of the factors that affect the kidney vasculature and blood pressure ( 117 ). In contrast, other studies have observed a reduced prevalence of micro/macroalbuminuria in obese children with T1D compared to those with healthy weight.…”

Section: Obesity As a Factor Of Developing T1d Vascular Complicationsmentioning

confidence: 99%

Multi-Faceted Influence of Obesity on Type 1 Diabetes in Children – From Disease Pathogenesis to Complications

et al. 2022

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The prevalence of overweight and obesity among youth patients with diabetes type 1 is increasing. It is estimated, that even up to 35% of young patients with this type of diabetes, considered so far to be characteristic for slim figure, are overweight or even obese. General increase of obesity in children’s population complicates differential diagnosis of the type of diabetes in youths. Coexistence of obesity has clinical implications for all stages of diabetes course. It is confirmed that obesity is the risk factor for autoimmune diabetes, and is connected with the earlier onset of diabetes in predisposed patients. Many diabetic patients with obesity present additional risk factors for macroangiopathy, and are recognised to present metabolic syndrome, insulin resistance, and typical for diabetes type 2 - polycystic ovary syndrome, or non-alcoholic fatty liver disease. The prevalence of obesity rises dramatically in adolescence of diabetic child, more often in girls. It has negative impact on metabolic control, glycaemic variability and insulin demand. The risk for microangiopathic complications increases as well. The treatment is difficult and includes not only insulinotherapy and non-pharmacological trials. Recently treatment of insulin resistance with biguanids, and treatment with typical for type 2 new diabetes drugs like GLP-1 analogues, SGLT-2 receptor inhibitors, or even cases of bariatric surgery also has been reported.

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Early functional and metabolic disorders in children with type I diabetes mellitus and diabetic nephropathy

Cited by 5 publications

References 27 publications

Analysis of Apoptotic, Clinical, and Laboratory Parameters in Type 1 Diabetes and Early Diabetic Nephropathy: Clustering and Potential Groups Evaluation for Additional Therapeutic Interventions

Analysis of Apoptotic, Clinical, and Laboratory Parameters in Type 1 Diabetes and Early Diabetic Nephropathy: Clustering and Potential Groups Evaluation for Additional Therapeutic Interventions

Research progress on the role of ET‐1 in diabetic kidney disease

Multi-Faceted Influence of Obesity on Type 1 Diabetes in Children – From Disease Pathogenesis to Complications

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