RESUMO
Diabetes is the 6th most important cause of disability burden in Egypt. Cardiovascular diseases are the leading cause of death in diabetics. Oxidative stress is involved in p-cell destruction and is recognized as a mediator in the development of macrovascular or cardiovascular complications in type 1 diabetes meliitus. Products of arachidonic acid metabolism elicit inflammatory responses and diseases in diabetic children such as atherosclerosis. Hyperglycemia induced activation of thromboxane pathway evidenced by increase urinary excretion of 11-dehydrothromboxane B2 [indicator of oxidative stress]. This study measured urinary excretion of 11 dehydro-thromboxane B2 in 40 type 1 diabetic children [12.38 +/- 2.75] years and 40, age and gender matched, healthy controls [10.88 + 3.23] years. Mean urinary 11 dehydrothromboxane B2 concentrations showed statistical significant difference between diabetic group [1884.8 + 826.86 pg/mg creatinine] and controls [601.95 + 229.24 pg/mg creatinine, p<0.001]. Also, total cholesterol [183.75 + 30.47 versus 112.6 + 27.07 mg/dl, p<0.001], triglycendes [147.45 + 29.91 versus 73.08 + 13.3, p<0.001], HDL [34.8 + 4.95 versus 45.6 + 8.25 mg/dl, p<0.001], LDL [120.9 + 30.5 versus 83.6 + 24.2 mg/dl, p<0.001], HbAlC [11.48 + 1.79 versus 5.37 + 0.59, p<0.001] and fasting C-peptide [0.33 + 0.14 versus 2.05 + 0.87, p<0.001] showed statistical significant difference between diabetic children and adolescents and healthy controls. Our results showed also significant positive correlation between urinary 11-dehydrothromboxane B2 and HbAlc [r= 0.627, p= 0.012], tnglycerides [r= 0.520, p= 0.047] and total cholesterol [r= 0.668, p= 0.007]. In conclusion, the increase of triglycerides and LDL-cholesterol levels in our study confirmed the dyslipidemia pattern in pediatric type 1 DM patients. Our results confirmed that hyperglycemia induced activation of thromboxane pathway in type 1 diabetic children and adolescents as evidenced by increase urinary excretion of the indicator of oxidative stress status 11-dehydrothromboxane B2. Also, we showed a significant positive correlation between the urinary excretion of 11-dehydrothromboxane B2 and the laboratory parameters of lipid metabolism. Therefore, urinary 11-dehydrothromboxane B2 can be used as a potential non invasive biomarker of dyslipidemia in type 1 diabetic children
RESUMO
Spontaneous preterm birth remains a significant problem allover the world despite increase research to decrease its prevalence. Strategies have been limited by inability to identify patients at risk for preterm birth, as the majority of patients don't have historical risk factors. The development of an assay to detect cervicovaginal fetal fibronectin [fFN], proinflammatory cytokines along with transvaginal cervical length determination has greatly increased our ability to identify those patients with high risk. We performed quantitative analysis of fFN, IL-1 beta, IL-6 and IL-8 in cervicovaginal secretions by ELISA to predict preterm delivered patients with intact membrane and cervical dilatation of = 3cm. Our results revealed marked significant increase in both cervicovaginal fetal fibronectin and IL-6 levels, and non significant increase for both cervicovaginal IL-1 beta and IL-8 in spontaneous preterm delivered patients compared with non preterm delivered patients. Furthermore, significant correlations were found between cervical lengths and both fFN and IL-6, while no significant correlations existed with other measured inflammatory cytokines. Our results concluded that fetal fibronectin and IL-6 may add a prognostic value to that provided by sonographic cervical length in patients with preterm uterine contractions and intact membranes