ABSTRACT
BACKGROUND: Endothelial dysfunction caused by chronic inflammation is the cornerstone of vascular complications in type 1 Diabetes-Mellitus (T1DM). Soluble Urokinase Plasminogen Activator Receptor (SuPAR) is a novel marker of inflammation and endothelial dysfunction. AIM: To evaluate SuPAR in T1DM children and correlate it to diabetic vascular complications. METHODS: Seventy T1DM children and 40 matched healthy controls were studied focusing on disease duration, insulin therapy and symptoms of diabetic complications. Blood-pressure, fundus and screening for peripheral-neuropathy were done. Fasting lipid profile, fraction-C of glycosylated hemoglobin (HbA1c%), Urinary albumin excretion (UAE), estimated-glomerular filtration rate (eGFR) and SuPAR were measured. Internal aortic diameter was measured with calculation of aortic distensibility and stiffness index. RESULTS: Sixteen T1DM patients(22.9%) had peripheral neuropathy, 12(17%) had nephropathy and none had retinopathy. SuPAR was significantly elevated in diabetic nephropathy (pâ¯<â¯0.01) and neuropathy (pâ¯<â¯0.01). Aortic stiffness index was significantly higher (pâ¯<â¯0.01) whereas, aortic strain and distensibility were significantly lower (pâ¯<â¯0.01) in T1DM than controls. SuPAR was significantly correlated to disease duration (pâ¯<â¯0.01), systolic blood pressure (pâ¯<â¯0.01), total cholesterol (pâ¯<â¯0.01), triglycerides (pâ¯<â¯0.01), UAER (pâ¯<â¯0.01) and aortic strain (0.013). CONCLUSION: Increased SuPAR early in diabetes might become a useful indicator of developing vascular complications. Further prospective studies are needed to determine the cut-off level of SuPAR for detection of T1DM and its complications.
