Relation of Interleukin-1 Receptor Antagonist with C-Peptide in Children with Type 1 Diabetes Mellitus

Abstract

Diabetes mellitus is a metabolic syndrome characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The vast majority of cases of diabetes fall into two broad etiopathogenetic categories, type 1 and type 2 (previously called juvenileonset and adult-onset, respectively). The incidence and prevalence of type 1 diabetes (T1D) is rapidly increasing worldwide especially in young children. T1D accounts for 5-10% of all cases of diabetes mellitus. T1D is a chronic T cell-mediated disease resulting from autoimmune destruction of pancreatic beta-cells. A functional imbalance in cytokine production resulting in dominance of T- helper 1(Th1) over Th2-type response has been suggested to play a critical role in the pathogenesis of T1D. Th1 cytokines provoke macrophage activation for the production of inflammatory mediators such as IL-1β. This cytokine is involved in the cytotoxicity and apoptotic death of the insulin-secreting cells in T1D patients. Interleukin-1 receptor antagonist (IL-1ra) is the natural antagonist of IL-1β. There are mounting evidences to suggest that anti-inflammatory IL- 1ra reduces the inflammatory effects of IL-1beta and preserves beta-cell function in T1D. Connecting peptide (C-peptide) is a product of proinsulin cleavage. C-peptide level is the most reliable factor evaluating the endogenous insulin secretion in patients with T1D. Summary 217 Little information is available on the association of these cytokines with endogenous C-peptide secretion and metabolic status in patients with T1D. This a prospective randomized case-control study was carried out to assess the association of C-peptide as a marker of β-cell function with systemic cytokine IL-1ra concentration during the first 6 months after diagnosis in children with type 1 diabetes. Thirty infants and young children with ages ranging from 6 months to prepuberty who were newly diagnosed patients with type 1 diabetes mellitus attending the Pediatric Diabetes Clinic, Children's Hospital, Ain Shams University were enrolled in the study as well as thirty age and sex matched healthy children that were included as control group. All patients and controls were subjected to history taking, thorough clinical examination and laboratory investigations including blood glucose, glycated haemoglobin, lipid profile, C-peptide and IL-1ra by ELISA technique. The study revealed the following results: 1- There was no significant correlation between IL-1ra and neither fasting C-peptide nor stimulated C-peptide among diabetic patients and the control group at time of diagnosis or at time of follow up