Circulating Oxidized Low-Density Lipoprotein and Intracellular Adhesion Molecule-1 in Type 1 Diabetic Adolescents

Abstract

Morbidity and mortality in type 1 diabetic patients derive mainly from advanced microvascular and macrovascular complications. Recent studies indicate that systemic markers of inflammation can identify subjects at high risk of cardiovascular disease (CVD). Oxidized low density lipoprotein (Ox-LDL) levels have been regarded as one of the independent determinants of atherosclerosis. Aim of the study: To investigate the significance of oxidized LDL and ICAM1 as a markers for early detection of microvascular and macrovascular complications in children and adolescents with type 1 diabetes mellitus. Methodology: This cross sectional case-control study involved a total 90 subjects including 30 type 1 diabetics without complications, 30 type 1 diabetics with complications, and 30 non-diabetic controls between the ages of 10 to 18 years. A detailed medical history was taken from each subject and the individuals with history of type-1 diabetes underwent clinical examination. Individuals with hypertension, smoking, and chronic infections, autoimmune and renal diseases were excluded. Serum concentrations of glucose, lipid profile, oxidized LDL and ICAM1 were measured. Carotid intima media thickness was measured by ultrasound. Results: The diabetic cases were 26 (43.3%) males and 34 (56.7%) females. The control subjects were 12 (40%) males and 18 (60%) females. The mean diabetes duration was 7.88± 2.69 years, all the studied subjects were on multiple daily injection insulin regimen with variable glycemic control as assessed by the mean HbA1c (10.82±2.10%) in complicated group and (8.30±1.88) in non complicated group. The mean total daily insulin dose was (1.64±0.69 unit per kg per day) in complicated group and (1.27±0.62 unit per kg per day) in non complicated group. Diabetic patients had significantly elevated levels of blood glucose (208.75.1vs 89.63 mg/dl), oxidized LDL (79.83vs 24.24 u/l), and ICAM1 (438.20vs 154.15 ng/ml) as compared to controls (p<0.001).