Type 1 Diabetes and Thyroid Autoimmunity in Children.

INTRODUCTION: Autoimmune thyroid disease and type 1 diabetes (T1DM) are two autoimmune diseases frequently associated, especially in pediatric population. Aims: we wanted to determine and ilustrate the relationship between type 1 diabetes and autoimmune thyroiditis and also the factors than can influence it, like gender, age, diabetes duration. Glycemic control was also evaluated for all the patients. MATERIAL AND METHODS: There were studied 256 patients, children and adolescents with T1DM (male/ female: 145/115; 55%/45%). Anti-TPO antibodies were detected using the electrohemiluminescence method and glycosylated haemoglobin A1c (HbA1c) was measured through a imunoturbidimetric method. The patients were clinically examined, including thyroid gland palpation, blood pressure measurement and assessment of their pubertal status and growth. RESULTS: Age distribution at the time of T1DM diagnosis: most of them, 26% were diagnosed between 6 and 9 years, 23% between 1-3 years, 21% between 3-6 years, 19% between 9-12 years, 9% between 12-15 years, and very few of them (2%) were diagnosed between 15 and 18 years. Among these patients, 47/256 (18.3 %) were positive for thyroid antibodies (anti - TPO). In 2 of 47 patients tests for anti TPO antibodies were positive at the time of T1DM diagnosis. Tests for anti - TPO antibodies became positive with an average of 5.09±3.84 ( range 0-13) years after the diagnosis of T1DM. At the time that anti - thyroid antibodies were first seen to be positive all patients were euthyroid with a mean age of 11.3 years (range 4 -16) and a mean diabetes duration of 5.21±3.57 (range 0-9 years). After 5±3.3 years (range 0- 9 years) a progression towards subclinical hypothyroidism due to Hashimoto thyroiditis was observed in 41 from 47 patients (87.2%), while no patient developed clinical hypoythyroidism. It was observed an 9.2 % ±1.5% mean value of HbA1c in patients with thyroiditis comparative with 7.9 % ± 0.7 % mean HbA1c value in those without thyroiditis. CONCLUSIONS: Thyroid autoimmunity is frequently present among T1DM patients, can be associated with increased age, female gender, long diabetes duration, and can inbalance the glycemic control of T1DM patients.

Erythrocyte caspase-3 and antioxidant defense is activated in red blood cells and plasma of type 2 diabetes patients at first clinical onset.

OBJECTIVES: We studied erythrocyte (RBC) caspase-3 activity and oxidative status in plasma and RBCs of 33 patients with type 2 diabetes at first clinical onset and 23 age-matched non-diabetes control subjects. METHODS: Caspase-3 activity was assayed during the life span of RBCs; lipid peroxides and total antioxidant capacity (TEAC) were assessed in plasma and RBCs as indicators of oxidative stress and non-enzymatic antioxidant defense; and superoxide dismutase, catalase, and glutathione peroxidase activity were measured in RBCs as enzymatic antioxidants. RESULTS: We found that, compared to controls, RBCs caspase-3 is activated early in type 2 diabetes (P < 0.05); TEAC and malondialdehyde increased in plasma of patients with early diabetes, even when hypertension and macroangiopathy were present (P < 0.01); and RBCs TEAC, malondialdehyde (P < 0.01), superoxide dismutase, and glutathione peroxidase (P < 0.05) exhibited similar behavior in patients with diabetes and hypertensive patients with diabetes. DISCUSSION: Increased antioxidant defense in plasma and RBCs of early type 2 diabetes patients is a potential mechanism that can overcome oxidative damage induced by reactive oxygen species overproduction, and occurs even in RBCs with a decreased life span. This observation could provide a possible explanation for the controversial effects of antioxidant supplementation in diabetes patients.

Curcumin and a Morus alba extract reduce pro-inflammatory effects of resistin in human endothelial cells.

Resistin is a cytokine which plays an important role in cardiovascular disease by influencing systemic inflammation and endothelial activation. In human endothelial cells (HEC) it increases the expression of P-selectin and fractalkine, and enhances monocyte adhesion by antioxidant mechanisms. This study investigated whether the natural antioxidants curcumin (CC) and an extract of Morus alba leaves (MA) have protective effects in resistin-activated HEC. HEC were exposed to 100 ng/mL resistin for 6 and 18 h in the absence or presence of MA or CC and the expression of fractalkine and P-selectin was determined by RT-PCR and western blot. Intracellular accumulation of reactive oxygen species (ROS) was monitored by fluorimetry and NADPH oxidase activity by a lucigenin-enhanced chemiluminescence assay. In addition, adhesion assays using the monocytic U937 cells were performed. The results showed that treatment of HEC exposed to resistin with MA and CC: (1) inhibited significantly P-selectin and fractalkine expression, (2) inhibited the increase in the intracellular ROS level, (3) reduced NADPH activation and (4) reduced monocytes adhesion to HEC. The results indicate that MA and curcumin target resistin-induced human endothelial activation partly via antioxidant mechanisms and suggest that they may represent therapeutic agents in vascular disease mediated by resistin.