Serum TNF-alpha level predicts nonproliferative diabetic retinopathy in children

Mediators Inflamm. 2007:2007:92196. doi: 10.1155/2007/92196.

Abstract

The aim of this study was identification of the immunologic markers of the damage to the eye apparatus at early stages of diabetes mellitus (DM) type 1 children. One hundred and eleven children with DM type 1 were divided into two groups: those with nonproliferative diabetic retinopathy (NPDR) and without retinopathy. All the children had their daily urine albumin excretion, HbA1c, C-peptide measured, 24-hour blood pressure monitoring, and ophthalmologic examination. Levels of TNF-alpha, IL-6, and IL-12 in serum were measured by ELISA tests (Quantikine High Sensitivity Human by R&D Systems, Minneapolis, Minn, USA). The NPDR children demonstrated a significantly longer duration of the disease in addition to higher HbA1c, albumin excretion rate, C-reactive protein, systolic blood pressure, as well as TNF-alpha and IL-6 levels than those without retinopathy. The logistic regression revealed that the risk of NPDR was strongly dependent on TNF-alpha [(OR 4.01; 95%CI 2.01-7.96)]. TNF-alpha appears to be the most significant predictor among the analyzed parameters of damage to the eye apparatus. The early introduction of the TNF-alpha antagonists to the treatment of young patients with DM type 1 who show high serum activity of the TNF-alpha may prevent them from development of diabetic retinopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Albuminuria / metabolism
  • Blood Pressure
  • C-Reactive Protein / metabolism
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetic Retinopathy / blood*
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / etiology
  • Enzyme-Linked Immunosorbent Assay
  • Glycated Hemoglobin / metabolism
  • Humans
  • Interleukin-12 / blood
  • Interleukin-6 / blood
  • Logistic Models
  • Predictive Value of Tests
  • Tumor Necrosis Factor-alpha / blood*

Substances

  • Glycated Hemoglobin A
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Interleukin-12
  • C-Reactive Protein