title: Nocturnal activity of 11β-hydroxy steroid dehydrogenase type 1 is increased in type 1 diabetic children.
abstract: OBJECTIVE
  The objective of this study was to investigate low-grade inflammation in children with type 1 diabetes (T1D) and its association with cortisol levels as well as its bioavailability through 11β-hydroxy steroid dehydrogenase type 1 (11β-HSD1) activity.
  
  
  METHODS
  Children with T1D (n=45) and their non-diabetic siblings (n=28) participated in the study. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (CRPhs) were measured between 1400 and 1800h. Glucocorticoid metabolites were measured in the first morning urine on clinic day and 11β-HSD1 activity was estimated by tetrahydrocortisol/tetrahydrocortisone (THF/THE) ratio.
  
  
  RESULTS
  Diabetic patients presented with an increased THF/THE ratio compared with controls (median: 0.68 [range: 0.45-1.18] vs 0.45 [0.27-0.98], respectively; P<10(-3)). There was no difference between diabetic patients and controls for IL-6 (0.6ng/mL [0.6-6.8] vs 0.6 [0.6-2.2], respectively; P=0.43) and CRPhs (0.4mg/L [0-7.4] vs 0.3 [0-8.2]; P=0.26, respectively). When adjusted for age, gender and BMI, the THF/THE ratio was significantly associated with CRPhs (β=0.32, P=0.02) in diabetic patients, but not in controls.
  
  
  CONCLUSIONS
  Low-grade inflammation assessed by plasma CRPhs and IL-6 concentrations was not detectable in our cohort of T1D children. Nocturnal 11β-HSD1 activity was increased and associated with plasma CRPhs concentration in diabetic patients. These results may be explained by either a direct or inflammation-mediated effect of the relative hepatic lack of insulin due to subcutaneous insulin therapy.
authors.affiliation: Service d'endocrinologie pédiatrique, CHU de Bordeaux, hôpital des Enfants, 33000 Bordeaux, France. pascal.barat@chu-bordeaux.fr
authors.forename: P
authors.initials: P
authors.lastname: Barat
authors.forename: J
authors.initials: J
authors.lastname: Brossaud
authors.forename: A
authors.initials: A
authors.lastname: Lacoste
authors.forename: V
authors.initials: V
authors.lastname: Vautier
authors.forename: F
authors.initials: F
authors.lastname: Nacka
authors.forename: M-P
authors.initials: MP
authors.lastname: Moisan
authors.forename: J-B
authors.initials: JB
authors.lastname: Corcuff
mesh_terms: D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1 / Q000097:blood*; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D005260:Female; D005602:France / Q000453:epidemiology; D005938:Glucocorticoids; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007249:Inflammation / Q000097:blood; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D035781:Siblings; D013997:Time Factors
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D007004:Hypoglycemic Agents; D007328:Insulin; D015850:Interleukin-6; D002097:C-Reactive Protein; D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1; D006854:Hydrocortisone