Osteopontin as a marker of vasculopathy in pediatric patients with type 1 diabetes mellitus: Relation to vascular structure.

BACKGROUND: Type 1 diabetes mellitus (T1DM) is associated with serious micro-vascular and macro-vascular complications. Osteopontin (OPN) has emerged as a strong predictor of incipient diabetic nephropathy and a first-ever cardiovascular event in adults with T1DM. OPN is linked to coronary atherosclerosis in type 2 diabetes. The aim of the study was to test the hypothesis that OPN could be a potential marker for micro-vascular complications in children and adolescents with T1DM and we assessed its relation to carotid and aortic intima media thickness (CIMT and AIMT) as non-invasive index for subclinical atherosclerosis. METHODS: Eighty patients with T1DM ≤18 years were divided into 2 groups according to the presence of micro-vascular complications and compared with 40 age- and sex-matched healthy controls. Fasting blood glucose, high sensitivity C-reactive protein (hs-CRP), HbA1c, urinary albumin creatinine ratio (UACR), OPN, CIMT, and AIMT were assessed. RESULTS: Both CIMT and AIMT were significantly higher in patients with and without micro-vascular complications compared with healthy controls (P < .001). OPN concentrations were significantly elevated in all diabetic patients compared with controls (P = .002). OPN was also significantly higher in patients with micro-vascular complications than patients without (P < .001) but levels were comparable among those without complications and controls (P = .322). Receiver operating characteristic curve analysis revealed that OPN cut-off value 90 ng/mL could differentiate patients with and without micro-vascular complications with 81.7% sensitivity and 95.8% specificity. Significant positive correlations were found between OPN and HbA1c, UACR, CIMT, and AIMT. CONCLUSIONS: OPN could be considered a marker of vasculopathy and subclinical atherosclerosis in pediatric T1DM.

Fatty acid binding protein 1 (FABP1) and fatty acid binding protein 2 (FABP2) as a link between diabetic nephropathy and subclinical atherosclerosis in children and adolescents with type 1 diabetes.

BACKGROUND: Diabetic nephropathy is a major cause of morbidity and mortality in type 1 diabetes mellitus (T1DM). Fatty acid binding proteins (FABP1 and FABP2) play a role in the development and progression of chronic kidney disease including type 2 diabetes mellitus. AIM: We assessed serum FABP1 and FABP2 levels in children and adolescents with T1DM as potential markers for diabetic nephropathy and their relation to carotid intima media thickness (CIMT). METHODS: Sixty patients with T1DM were divided into 2 groups according to the presence of nephropathy and compared with 30 healthy controls. CIMT, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), urinary albumin creatinine ratio (UACR), fasting lipid profile and serum FABP1 and FABP2 levels were assessed. RESULTS: FABP1 and FABP2 levels were significantly higher among type 1 diabetic patient with and without nephropathy compared with healthy controls with the highest levels among patients with nephropathy (p < 0.001). There were significant positive correlations between FABP1 and FABP2 and each of systolic blood pressure, CIMT, FBG, HbA1c and total cholesterol among T1DM patients. FABP1 was negatively correlated to glomerular filtration rate. Multivariable linear regression analysis showed that systolic blood pressure, CIMT, FBG and HbA1c were the significant independent variables related to FABP1 levels in type 1 diabetic patients with nephropathy. ROC curve analysis was performed to determine the cutoff value of FABP1 and FABP2 that could detect nephropathy. CONCLUSION: FABP1 and FABP2 levels are elevated in children and adolescents with T1DM and could represent a link between diabetic nephropathy and subclinical atherosclerosis.

Cognitive functions in children and adolescents with early-onset diabetes mellitus in Egypt.

The objective of this study was to investigate performance on memory, intelligence, and executive functions in children and adolescents with type 1 diabetes mellitus (T1DM) and to investigate the role of glycemic control, hypoglycemic attacks and diabetic ketoacidosis. We compared 50 subjects with T1DM with 30 healthy controls (ages between 7 and 16 years) using Benton Visual Retention Test (BVRT), the Arabic version of the Wechsler Intelligence Scale for Children (WISC), and Wisconsin Card Sorting Test (WCST). We also compared good versus poor glycemic control in T1DM subjects. RESULTS: T1DM subjects had significantly poorer performance than controls on all subtests of the BVRT, on all subscales of the WISC (verbal, performance and total IQ) and on most subtests of WCST (p < 0.05). T1DM subjects with good glycemic control performed significantly better than subjects with poor glycemic control on all subtests of the BVRT and on all subscales of the WISC (p < 0.05), but there was no difference on the WCST. T1DM subjects differed from controls on memory, intelligence, and executive functions. They also differed according to good or poor glycemic control (except on the WCST). Cognitive performance significantly correlated with a number of demographic and clinical variables.