study of some biochemical indices of early complications in diabetic children in Assiut

ABSTRACT

A study of some biochemical indices of early complications in diabetic children, was done. Plasma and urinary N-acetyl-B-glucosaminidase [NAG], B2-microglobulin [B2-MG], sialic acid as well as plasma fibronectin and lipid peroxides were determined in 23 children with insulin dependent diabetic children as well as 16 healthy children of matchable age and sex. Thirteen of these children had recently diagnosised disease while 10 were previously known to be diabetic. Urinary NAG and B2-MG excretions were significantly increased in diabetic compared to healthy children. Both indices were significantly intercorrelated and correlated with both blood glucose and whole blood glycosylation, which are indices of short and long term glycaemic control. These changes suggest the presence of reversible proximal renal tubular dysfunction. Plasma NAG activity was also significantly increased in diabetic children and correlated with urinary NAG and blood glucose as well as whole blood glycosylation levels. Plasma fibronectin and lipid peroxides levels were significantly increased in diabetic compared with control children. Both indices correlated significantly with whole blood glycosylation, and lipid peroxides correlated also with blood glucose levels. Plasma and urine sialic acid were significantly increased in diabetic compared with healthy children, both biomarkers were significantly correlated with blood glucose levels as well as whole blood glycosylation. No significant differences in the levels of the previous markers could be observed in diabetic children with a disease duration more than 1 year versus those with less than 1 year. The present results suggest that diabetic complications could occur early in the course of disease especially in poorly controlled subjects. These complications are not clinically manifest and could be in the reversible pre-clinical stage. These children should receive more strict observation and be screened by determination of urinary or plasma NAG together with plasma sialic acid and lipid peroxides, based on sensitivity, cost and stability of various indices