title: Insulin-like growth factor-1 cytokines cross-talk in type 1 diabetes mellitus: relationship to microvascular complications and bone mineral density.
abstract: OBJECTIVE
  This study was designed to investigate the association between inflammatory cytokines (IL-8, IL-6) and IGF-1 levels in relation to metabolic control, microvascular complications and bone mineral density (BMD) in a cohort of Egyptian adolescents with T1DM.
  
  
  METHODS
  Sixty patients with T1DM (mean age was 14.67±1.53 years, mean disease duration was 6.87±1.25 years) and 40 controls participated in the study. Thirty-six patients (60%) had poor glycemic control (HbA1C measurements ≥8%) while the rest (n=24%, 40%) had good glycemic control (HbA1C measurements <8%). Serum IL-6, IL-8, and IGF-1 levels were measured. Whole body DXA scan were assessed. Total body and lumbar spine (L2-L4) bone mineral content (BMC, g) and bone area (BA, cm(2)) were measured by DXA scan, bone mineral density (BMD, g/cm(2)) was calculated by BMC/BA.
  
  
  RESULTS
  Patients with T1DM had higher IL-6 and IL-8 levels with lower IGF-1 than healthy controls (P<0.001). Within the T1DM patients those with poor glycemic control had higher IL-6 and IL-8 as well as lower IGF-1 and total BMD than those with good glycemic control (P<0.001 for all). IL-6 and IL-8 were negatively correlated with IGF-1 (P=0.005 and 0.021, respectively). The peripheral neuropathy rate was also greater in T1DM patients with poor glycemic control (P=0.02). Presence of nephropathy or retinopathy was not different (P=0.69 and 0.50, respectively).
  
  
  CONCLUSIONS
  High IL-6, IL-8 with low IGF-1 levels are found in adolescents with T1DM. It seems that poor glycemic control exacerbates inflammatory cytokines, increases peripheral neuropathy, and decreases bone mineral density.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: AboElAsrar
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Elbarbary
authors.forename: Dina E
authors.initials: DE
authors.lastname: Elshennawy
authors.forename: Amin M
authors.initials: AM
authors.lastname: Omar
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications; D018836:Inflammation Mediators / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D055806:Microvessels / Q000473:pathology* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D016209:Interleukin-8; D007334:Insulin-Like Growth Factor I