The prognostic value of inflammatory and vascular endothelial dysfunction biomarkers in microvascular and macrovascular complications in type 1 diabetes

Abstract

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease characterised by a destruction of pancreatic β cells, which leads to absolute insulin deficiency. Persistently high glycaemia causes vascular damage throughout the body. Microvascular complications comprise the following: nephropathy, retinopathy, and neuropathy. Macrovascular complications include coronary heart disease (CHD), which may result in myocardial infarction, cerebrovascular disease (leading to strokes), and peripheral vascular disease. The pathogenesis of vascular complications is multifactorial and is probably the combination of direct glucose-mediated endothelial damage, oxidative stress, production of sorbitol, and advanced glycation end-products. Precise understanding of these mechanisms could help clinicians to identify diabetic complications earlier and subsequently implement indispensable therapy on time. It is vital to determine biomarkers of microvascular and macrovascular complications in children affected with T1DM. Advanced glycation end-products and their receptors, adhesive molecules, pro-and anti-inflammatory cytokines, enzymes such as N-acetyl-β-D-glucosaminidase, and growth factors are the subject of ongoing studies. Numerous biomarkers of diabetic microangiopathy are already known and may constitute therapeutic targets in the future. Unfortunately, despite substantial progress in the understanding of the processes by which microvascular and macrovascular complications develop, much effort still needs to be devoted to the matter, and further investigations are required.

Amelioration of Endothelial Dysfunction and Inflammation in Type 2 Diabetic Patients after Black Seed Oil Supplementation.

“…It was observed in the present study that hsCRP and sICAM-1 levels were elevated in diabetic patients compared to healthy volunteers, which are following previous studies that demonstrated the increased level of these markers in diabetic patients and their association with future diabetic complications and mortality [20,23]. At the current work, a statistically significant reduction in hsCRP levels in the intervention group was found following randomized controlled trials which demonstrated the beneficial effect of NS on the CRP level of patients with different disease states [34].…”

Application of Differential Network Enrichment Analysis for Deciphering Metabolic Alterations

“…In T1D, there are marked changes in the intestinal morphology and expression of transporters [42] and increased intestinal permeability [43], altering the entry of exogenous substances with additional effects on cellular metabolism. These findings also support previously described disruptions in metabolism associated with T1D, including alterations in mitochondrial metabolism, increased oxidative stress, and changes in redox state [44]. Indeed, Fahrmann et al [24] previously reported increased levels of sugar-related metabolites, branched chain amino acids, gluconic acid and nitric oxide-derived saccharic acid markers of oxidative stress in T1D mice.…”

What can we learn from β-cell failure biomarker application in diabetes in childhood? A systematic review

“…According to the International Diabetes Federation the incidence rate in T1DM is increasing steadily, particularly in the pediatric population. In 2019, 1106200 children and adolescents under 20-years-old were affected by T1DM worldwide thus worsening their life quality and presenting early in life with complications that may even result into life-threatening conditions[ 19 ]. The pathophysiology underlying the development of T1DM has been widely studied and has not yet been completely elucidated.…”

“…Despite the great effort and substantial progress that has been made in the understanding of the pathophysiology underlying the micro- and macrovascular complications of DM, further investigation is still required. Advanced glycation end products and their receptors, adhesive molecules, pro- and anti-inflammatory cytokines, enzymes such as N-acetyl-β-D-glucosaminidase and growth factors represent the main subject of ongoing studies[ 19 ].…”