Oxidative stress in youth with type 1 diabetes: Not only a matter of gender, age, and glycemic control.

ABSTRACT

AIMS: We assessed whether oxidative stress (OS) is increased in children/adolescents with type 1 diabetes (T1D) compared to healthy peers. Moreover, we searched for OS predictors in the T1D population. METHODS: We compared the concentration of serum derivatives of reactive oxygen metabolites (d-ROMs) in 412 children/adolescents with T1D (3.6-23.5 years old) to that of 138 healthy children/adolescents (1.2-19.2 years old) by ANOVA adjusted for age, gender, and BMI z-score (z-BMI). Applying a general linear model, in a subgroup of 331 patients using continuous glucose monitoring, we searched for predictors of d-ROMs among 3-day, 2-week, and 4-week metrics of glucose control and variability, such as mean blood glucose, percent time in range (70-180 mg/dl,TIR70-180), coefficient of variation, and others, as well as among conventional cardiovascular risk factors like current and average HbA1c, z-BMI, blood pressure percentiles, and lipid concentrations recorded retrospectively over the entire follow-up period. RESULTS: D-ROMs levels were significantly higher in children/adolescents with T1D compared to controls [371.9 (64.2) versus 324.9 (46.3), p < 10-16]. Sex (B = 49.1, ƞ2 = 0.14, p = 1.3 * 10-9), age < 12 years in boys (B = 79.4, ƞ2 = 0.074, p = 10-7),3-day TIR70-180 (B = -0.87, ƞ2 = 0.048, p = 6.5 * 10-5), and z-BMI (B = 7.4, ƞ2 = 0.016, p = 0.022) predicted d-ROMs with an overall R2 of 0.278. CONCLUSIONS: OS is increased in youth with T1D and only partially predicted by gender, age, glucose control, and anthropometry. Other potential determinants of OS in this population should be targeted in future studies.