Relación de IMC con marcadores de inflamación y hemoglobina glicosilada en niños y jóvenes con diabetes mellitus 1 / Relationship of BMI with markers of inflammation and glycosylated hemoglobin in children and young adults with diabetes mellitus 1

La diabetes mellitus tipo 1 (DM1) es una enfermedad autoinmune que genera dependencia exógena de insulina de forma permanente, presenta inflamación subclínica crónica lo que conlleva a una elevación de marcadores de inflamación como factor de necrosis tumoral alfa (TNF-α), proteína C reactiva (PCR) e interleuquina 6 (IL-6). OBJETIVO: determinar la relación entre el IMC sobre los marcadores de inflamación y el control metabólico en niños y jóvenes con DM1 entre 5 a 15 años de edad. METODOLOGÍA: Se realizó un estudio clínico, observacional, exploratorio. A partir de La recolección de datos de fichas clínicas y muestras de sangre en el Instituto de Investigaciones Materno Infantil (IDIMI) del Hospital San Borja Arriarán de la Universidad de Chile. Clasificación del estado nutricional utilizando datos registrados en ficha clínica. Marcadores de inflamación por medio de ELISA, hemoglobina glicosilada mediante métodos estándares. El análisis estadístico incluyó correlaciones mediante test de Spearman y diferencia de medias mediante test de Kruskal-Wallis seguido de post hoc Dunns. RESULTADOS: Un 30% de los pacientes con DM1 presentaron malnutrición por exceso. Al analizar la relación entre los niveles de marcadores inflamatorios y Hb glicosilada se observó la existencia de asociacion positiva entre usPCR y HbA1c (r= 0,30; p=0,0352) y entre IL-6 y HbA1c (r= - 0,038; p=0,0352). CONCLUSIONES: este estudio describe una posible asociación entre parámetros clásicos de inflamación con la hemoglobina glicosilada en las categorias de sobrepeso y obesidad en pacientes con DM1.

Type 1 diabetes mellitus (T1D) is an autoimmune disease that generates permanent exogenous insulin dependence, accompanied by chronic subclinical inflammation that leads to an elevation of inflammation markers such as tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6). OBJECTIVE: To determine the relationship between BMI on markers of inflammation and metabolic control in children and young people with T1D between 5 and 15 years of age. METHODOLOGY: A clinical, observational and exploratory study was carried out, based on the collection of data from clinical records and blood samples of children and adolescents with DM1 at the Instituto de Investigaciones Materno Infantil (IDIMI) of the Hospital San Borja Arriarán of the Universidad de Chile. Nutritional status, levels of inflammation markers and glycosylated hemoglobin were determined by standardized methods. Statistical analysis included correlations by Spearman test and mean difference by Kruskal-Wallis test followed by post hoc Dunns test. RESULTS: A total of 56 patients with T1D were analyzed, 30% of whom presented excess malnutrition. Those children or adolescents with obesity presented significantly higher usPCR levels compared to underweight patients or patients at risk of malnutrition (p=0.039). In addition, HbA1c levels were determined which were negatively associated with usPCR (r= 0.30; p=0.0352) and IL-6 (r= - 0.038; p=0.0352) levels. CONCLUSIONS: This study points out that nutritional status is associated with usPCR levels, in agreement with what is described in the literature and shows a possible association between classical parameters of inflammation with glycosylated hemoglobin in children and adolescents with nutritional diagnosis of overweight or obesity.

Relationship between Bone Morphological Microstructure and Inflammatory Markers in Growing Mice Fed a High Fat Diet

Obesity not only reduces bone mineral density but also increases inflammatory markers. Therefore, we examined the change in inflammatory markers and morphological microstructure of the bones using a mouse model fed a high-fat diet. C57BL/6J 4-week-old male mice were divided into a control group (n = 6) and a experimental group (n = 6); the control group was provided with 10% Kcal fat diet, and the high-fat diet group was provided with 45% Kcal fat diet for 12 weeks using the free provision method. Blood was analyzed for inflammatory markers, and micro-computed tomography was used to measure the morphological microstructure of the femoral bone. The weight increases in the control group and high-fat diet group were 5.85 +/- 1.84 g and 16.06 +/- 5.64 g, respectively (p < 0.01), glucose was 115.00 +/- 16.88 mg/dL and 188.33 +/- 13.29 mg/dL (p < 0.01), and triglycerides were 65.00 +/- 6.19 mg/dL and 103.33 +/- 8.02 mg/dL (p < 0.05) respectively. Leptin and interleukin (IL)-6 were significantly higher in the high-fat diet group than that in the control group (p < 0.01). As a result of a biochemical index analysis of bone metabolism, osteocalcin tended to be lower in the high-fat diet group, whereas CTx was significantly higher in the high-fat diet group compared to that in the control group (p < 0.01). The thickness of the bony trabecula was significantly narrower in the high-fat diet group than that in the control group (p < 0.05), and the gap in the bony trabecula was significantly wider in the high-fat diet group than that in the control group (p < 0.05). IL-6 and the gap in the bone trabecula, which was a morphological microstructure of the bones, showed a positive correlation (p < 0.05). Taken together, inducing obesity through a high-fat diet in mice during the growth phase caused a change in bone microstructure and was correlated with the inflammation index. Accordingly, restriction of excessive fat intake may be needed to suppress the inflammatory reactions and promote normal bone formation.

Relationship among plasma secretory phospholipase A2, oxidized low density lipoprotein & paraoxonase activities in hypertensive subjects treated with angiotensin converting enzyme inhibitors.

Background & objectives: Secretory phospholipase A2 (sPLA2) and oxidized low density lipoprotein (oxLDL) are considered as oxidative and inflammatory markers. The effects of oxLDL have been shown to be inhibited by paraoxonase (PON1). This study was undertaken to investigate the relationship between oxidative and inflammatory markers in hypertensive patients with or without antihypertensive drug treatment. Methods: Newly diagnosed hypertensive patients (n=35) and hypertensive patients who had been taking angiotensin converting enzyme (ACE) inhibitors as antihypertensive therapy (10 or 20 mg/day for 9 ± 2 wk; n=35) and age-matched normotensive subjects (controls; n=20) were included in this study. Plasma sPLA2, oxLDL and PON1 activities were determined. Results: Hypertensives had higher plasma oxLDL and sPLA2 levels (P<0.01) and lower PON1 levels than the controls (P<0.01). Treated hypertensives had lower plasma sPLA2 and oxLDL levels and higher PON1 activities than hypertensives (P<0.01). sPLA2 was positively correlated with oxLDL (r=0.433, P<0.01) and negatively correlated with plasma PON1 (r= - 0.540, P<0.01) in untreated hypertensives. In controls and treated hypertensives, plasma PON1 was positively correlated with oxLDL (r= 0.455, r=0.429, P<0.01, respectively) and sPLA2 (r= 0.450, r=0.506, P<0.01, respectively). Interpretation & conclusions: Reduction in PON1 activity and elevation in both sPLA2 activities and oxLDL levels might be involved in elevated oxidative stress and inflammation. ACE inhibitor treatment may help reduce inflammation and oxidative stress in hypertensives.