title: [TNF-α and soluble receptor TNF-α type 1 in children with diabetes mellitus type 1].
abstract: BACKGROUND
  TNF-α, and its soluble form sTNFR1, as proinflammatory hormone plays a great role in pathogenesis of auto immunological diseases, insulin resistance, both carbohydrates and fat metabolism and development of late complications in type 1 diabetes mellitus (DMT1) patients.
  
  
  OBJECTIVE
  To asses TNF-α and sTNFR1 levels in children with DMT1 and to analyze the correlation with anthropometric parameters, metabolic control and the influence of the kind of insulin therapy.
  
  
  METHODS
  67 patients, aged from 3.71 to 14.81 years (mean±SD: 10.33±2.21). All the children were prepubertal (T ≰2), suffering for DMT1, without any coexisting diseases. The duration of the disease varied from 1.83 to 9 years (mean±SD: 4,0±1,6), and the age at diagnosis oscillated between 1.84 to 10.81 years. All the patients were divided into subgroups according to the kind of therapy which was not changed in the last 6 months. 15 agematched healthy children were included into the study. There were no statistically significant differences between the groups as to the metabolic control, age, weight, height and BMI.
  
  
  RESULTS
  TNF-α levels in the study group ranged from 0.30 to 14.20 ng/ml (mean±1.62 ± 0.41 pg/ml) and were lower than in the control group: from 0.20 to 19.00 pg/ml (mean±SD: 1.67±1.41 pg/ml) (p >0.05). The highest TNF-α levels were observed in the insulin pump group, lower in the multiple insulin injection group and in the conventional insulin therapy group. The sTNFR1 in the study group ranged from 707.00 to 1646.00 pg/ml (mean±SD: 1028.18±181.24 pg/ml) and was higher than in the control group: 613.0 to 1310.00 pg/ml (mean±SD: 978.00±203.03 pg/ml) (p >0.05). The highest sTNFR1 levels were observed in the insulin pump group, lower in the multiple insulin injection group and the lowest in the conventional insulin therapy group.
  
  
  CONCLUSIONS
  TNF-α levels are lower in DMT1 children, correlate only with height and do not depend on the kind of insulin therapy. sTNFR1 levels are higher in children with DMT1, correlate with anthropometric parameters and do not depend on the kind of insulin therapy.
authors.affiliation: Klinika Endokrynologii i Diabetologii Instytutu Pomnik-Centrum Zdrowia Dziecka w Warszawie. mszalecki@wp.pl
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Szalecki
authors.forename: Ewa
authors.initials: E
authors.lastname: Pańkowska
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Piontek
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Wysocka-Mincewicz
authors.forename: Roman
authors.initials: R
authors.lastname: Janas
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D011044:Poland; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D012016:Reference Values; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D007328:Insulin; D047888:Receptors, Tumor Necrosis Factor, Type I; D014409:Tumor Necrosis Factor-alpha