title: Inflammatory markers are increased in youth with type 1 diabetes: the SEARCH Case-Control study.
abstract: BACKGROUND
  Increased inflammation may contribute to type 1 diabetes (T1D) complications.
  
  
  OBJECTIVE
  The objective of the study was to investigate the association of inflammation with obesity, hyperglycemia and dyslipidemia in youth with T1D.
  
  
  METHODS
  This was a cross-sectional study of youth with and without T1D.
  
  
  METHODS
  The study was conducted in Colorado and South Carolina.
  
  
  METHODS
  SEARCH Case-Control participants with T1D [n = 553, mean age 15 yr (range 10-22), median duration 2.7 yr] and without diabetes [n = 215, mean age 15 yr (range 10-22)].
  
  
  METHODS
  This was an observational study.
  
  
  METHODS
  IL-6, high-sensitivity C-reactive protein (hsCRP), fibrinogen, and leptin were measured.
  
  
  RESULTS
  Inflammatory markers were evaluated by diabetes status, quartiles of glycated hemoglobin, and obesity using multiple linear regression analyses, adjusted for age, sex, study site, race/ethnicity, T1D duration, body mass index, and pubertal status. Compared with controls, youth with T1D had higher IL-6 and fibrinogen levels at all levels of glycemia and obesity, and hsCRP levels were significantly higher in youth with T1D in the top three quartiles of glycated hemoglobin (> or = 7.2%) and among normal-weight subjects. Leptin was lower in youth with poor glycemic control. Higher hsCRP and fibrinogen were correlated with higher total and LDL cholesterol, and apolipoprotein B in youth with T1D, whereas higher fibrinogen was correlated with higher LDL and apolipoprotein B in controls.
  
  
  CONCLUSIONS
  T1D is characterized by excess inflammation, independent of adiposity and glycemic control. Even T1D youth in good glycemic control had higher levels of IL-6 and fibrinogen than controls. Elevated inflammatory markers were associated with an atherogenic lipid profile, which may contribute to accelerated atherosclerosis in youth with T1D.
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, P.O. Box 6511, Mail Stop A-140, Aurora, Colorado 80045, USA. janet.snell-bergeon@ucdenver.edu
authors.forename: Janet K
authors.initials: JK
authors.lastname: Snell-Bergeon
authors.forename: Nancy A
authors.initials: NA
authors.lastname: West
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Mayer-Davis
authors.forename: Angela D
authors.initials: AD
authors.lastname: Liese
authors.forename: Santica M
authors.initials: SM
authors.lastname: Marcovina
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hamman
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015415:Biomarkers; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood; D005006:Ethnicity; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications; D007249:Inflammation / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications; D011627:Puberty / Q000502:physiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D015850:Interleukin-6; D020738:Leptin