title: Increased systemic Th17 cytokines are associated with diastolic dysfunction in children and adolescents with diabetic ketoacidosis.
abstract: Diastolic dysfunction suggestive of diabetic cardiomyopathy is established in children with T1DM, but its pathogenesis is not well understood. We studied the relationships of systemic inflammatory cytokines/chemokines and cardiac function in 17 children with T1DM during and after correction of diabetic ketoacidosis (DKA). Twenty seven of the 39 measured cytokines/chemokines were elevated at 6-12 hours into treatment of DKA compared to values after DKA resolution. Eight patients displayed at least one parameter of diastolic abnormality (DA) during acute DKA. Significant associations were present between nine of the cytokine/chemokine levels and the DA over time. Interestingly, four of these nine interactive cytokines (GM-CSF, G-CSF, IL-12p40, IL-17) are associated with a Th17 mediated cell response. Both the DA and CCL7 and IL-12p40, had independent associations with African American patients. Thus, we report occurrence of a systemic inflammatory response and the presence of cardiac diastolic dysfunction in a subset of young T1DM patients during acute DKA.
authors.affiliation: Section of Pediatric Endocrinology, Georgia Regents University (formerly Georgia Health Sciences University), Augusta, Georgia, United States of America.
authors.forename: William H
authors.initials: WH
authors.lastname: Hoffman
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Passmore
authors.forename: David W
authors.initials: DW
authors.lastname: Hannon
authors.forename: Monica V
authors.initials: MV
authors.lastname: Talor
authors.forename: Pam
authors.initials: P
authors.lastname: Fox
authors.forename: Catherine
authors.initials: C
authors.lastname: Brailer
authors.forename: Dynita
authors.initials: D
authors.lastname: Haislip
authors.forename: Cynthia
authors.initials: C
authors.lastname: Keel
authors.forename: Glenn
authors.initials: G
authors.lastname: Harris
authors.forename: Noel R
authors.initials: NR
authors.lastname: Rose
authors.forename: Irma
authors.initials: I
authors.lastname: Fiordalisi
authors.forename: Daniela
authors.initials: D
authors.lastname: Čiháková
mesh_terms: D000293:Adolescent; D002648:Child; D016207:Cytokines / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000276:immunology / Q000503:physiopathology; D016883:Diabetic Ketoacidosis / Q000097:blood* / Q000276:immunology / Q000503:physiopathology; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D058504:Th17 Cells / Q000276:immunology / Q000378:metabolism; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000209:etiology / Q000276:immunology
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators