Kallistatin as a Marker of Microvascular Complications in Children and Adolescents with Type 1 Diabetes Mellitus
Shaimaa Mohamed Ahmed Salem;
Abstract
D
iabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia, resulting from defects in insulin secretion, insulin action or both. Type 1 diabetes mellitus is caused by deficiency of insulin secretion due to pancreatic β-cell damage.
The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs resulting in microvascular disease, such as nephropathy, retinopathy or neuropathy, and also macrovascular disease as atherosclerosis.
In diabetes, microvascular disease may be mediated by disturbances in the levels of or balance of pro- and anti-angiogenic factors, such as (anti-angiogenic) kallistatin.
Kallistatin (KS) is a serine proteinase inhibitor (serpin), was first identified as a tissue kallikrein-binding protein. It has anti-angiogenic, anti-oxidant and anti-inflammatory effects, anti-tumor, vasodilator effects. KS is synthesized primarily in the liver, but it is also widely expressed in organs such as the kidney, heart, and blood vessels. It has been found elevated in serum samples of patients with diabetes. However, circulating kallistatin levels in type 1 diabetic children and adolescents have not been widely explored.
Our study aimed to determine the level of serum Kallistatin in children and adolescents with type 1 diabetes as an early marker for micro-vascular complications as nephropathy, retinopathy or neuropathy and assess its relation to clinicolaboratory characteristics of the patients. Plasma Kallistatin levels were determined by immunosorbent assay (ELISA).
This cross sectional study was carried out on 65 children and adolescents with type 1 DM, with disease duration 5 years or more, attending the Pediatric Diabetes Clinic, Ain Shams University, from from April 2012 to April 2013. Their mean age was 14.1 ± 2.6 years (range, 9-18years), with mean disease duration 6.9 ± 1.7 years. Another group of 35 age- and sex-matched healthy individuals was enrolled as controls with a mean age was 13.2 ± 3.4 years (range, 4-18 years).
All included patients were subjected to detailed medical history (age of onset of diabetes, diabetes duration, insulin therapy, acute metabolic complications, symptomatic hypoglycemic attacks or episodes of diabetic ketoacidosis and chronic microvascular complications: retinopathy and neuropathy, thorough clinical examination stress on asessment of anthropometric measures and routine work up including; FBG, fasting lipid profile, mean HbA1c%, and CRP. Also, serum levels of Kallistatin were measured (ELISA).
iabetes Mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia, resulting from defects in insulin secretion, insulin action or both. Type 1 diabetes mellitus is caused by deficiency of insulin secretion due to pancreatic β-cell damage.
The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs resulting in microvascular disease, such as nephropathy, retinopathy or neuropathy, and also macrovascular disease as atherosclerosis.
In diabetes, microvascular disease may be mediated by disturbances in the levels of or balance of pro- and anti-angiogenic factors, such as (anti-angiogenic) kallistatin.
Kallistatin (KS) is a serine proteinase inhibitor (serpin), was first identified as a tissue kallikrein-binding protein. It has anti-angiogenic, anti-oxidant and anti-inflammatory effects, anti-tumor, vasodilator effects. KS is synthesized primarily in the liver, but it is also widely expressed in organs such as the kidney, heart, and blood vessels. It has been found elevated in serum samples of patients with diabetes. However, circulating kallistatin levels in type 1 diabetic children and adolescents have not been widely explored.
Our study aimed to determine the level of serum Kallistatin in children and adolescents with type 1 diabetes as an early marker for micro-vascular complications as nephropathy, retinopathy or neuropathy and assess its relation to clinicolaboratory characteristics of the patients. Plasma Kallistatin levels were determined by immunosorbent assay (ELISA).
This cross sectional study was carried out on 65 children and adolescents with type 1 DM, with disease duration 5 years or more, attending the Pediatric Diabetes Clinic, Ain Shams University, from from April 2012 to April 2013. Their mean age was 14.1 ± 2.6 years (range, 9-18years), with mean disease duration 6.9 ± 1.7 years. Another group of 35 age- and sex-matched healthy individuals was enrolled as controls with a mean age was 13.2 ± 3.4 years (range, 4-18 years).
All included patients were subjected to detailed medical history (age of onset of diabetes, diabetes duration, insulin therapy, acute metabolic complications, symptomatic hypoglycemic attacks or episodes of diabetic ketoacidosis and chronic microvascular complications: retinopathy and neuropathy, thorough clinical examination stress on asessment of anthropometric measures and routine work up including; FBG, fasting lipid profile, mean HbA1c%, and CRP. Also, serum levels of Kallistatin were measured (ELISA).
Other data
| Title | Kallistatin as a Marker of Microvascular Complications in Children and Adolescents with Type 1 Diabetes Mellitus | Other Titles | الكاليستاتين كمؤشر لمضاعفات الأوعية الدموية الدقيقة لدى مرضى النوع الأول من داء السكري عند الأطفال والبالغين | Authors | Shaimaa Mohamed Ahmed Salem | Issue Date | 2014 |
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