title: Serum TNF-alpha level predicts nonproliferative diabetic retinopathy in children.
abstract: The aim of this study was identification of the immunologic markers of the damage to the eye apparatus at early stages of diabetes mellitus (DM) type 1 children. One hundred and eleven children with DM type 1 were divided into two groups: those with nonproliferative diabetic retinopathy (NPDR) and without retinopathy. All the children had their daily urine albumin excretion, HbA1c, C-peptide measured, 24-hour blood pressure monitoring, and ophthalmologic examination. Levels of TNF-alpha, IL-6, and IL-12 in serum were measured by ELISA tests (Quantikine High Sensitivity Human by R&D Systems, Minneapolis, Minn, USA). The NPDR children demonstrated a significantly longer duration of the disease in addition to higher HbA1c, albumin excretion rate, C-reactive protein, systolic blood pressure, as well as TNF-alpha and IL-6 levels than those without retinopathy. The logistic regression revealed that the risk of NPDR was strongly dependent on TNF-alpha [(OR 4.01; 95%CI 2.01-7.96)]. TNF-alpha appears to be the most significant predictor among the analyzed parameters of damage to the eye apparatus. The early introduction of the TNF-alpha antagonists to the treatment of young patients with DM type 1 who show high serum activity of the TNF-alpha may prevent them from development of diabetic retinopathy.
authors.affiliation: Department of Immunology, Medical University of Gdańsk, Debinki 1, 80-210 Gdańsk, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zorena
authors.forename: Jolanta
authors.initials: J
authors.lastname: Myśliwska
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Myśliwiec
authors.forename: Anna
authors.initials: A
authors.lastname: Balcerska
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Hak
authors.forename: Paweł
authors.initials: P
authors.lastname: Lipowski
authors.forename: Krystyna
authors.initials: K
authors.lastname: Raczyńska
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000473:pathology; D003930:Diabetic Retinopathy / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D018664:Interleukin-12 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016015:Logistic Models; D011237:Predictive Value of Tests; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D018664:Interleukin-12; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha