Inflammatory markers are increased in youth with type 1 diabetes: the SEARCH Case-Control study

J Clin Endocrinol Metab. 2010 Jun;95(6):2868-76. doi: 10.1210/jc.2009-1993. Epub 2010 Apr 6.

Abstract

Context: Increased inflammation may contribute to type 1 diabetes (T1D) complications.

Objective: The objective of the study was to investigate the association of inflammation with obesity, hyperglycemia and dyslipidemia in youth with T1D.

Design: This was a cross-sectional study of youth with and without T1D.

Setting: The study was conducted in Colorado and South Carolina.

Patients: SEARCH Case-Control participants with T1D [n = 553, mean age 15 yr (range 10-22), median duration 2.7 yr] and without diabetes [n = 215, mean age 15 yr (range 10-22)].

Intervention: This was an observational study.

Main outcome measures: IL-6, high-sensitivity C-reactive protein (hsCRP), fibrinogen, and leptin were measured.

Results: Inflammatory markers were evaluated by diabetes status, quartiles of glycated hemoglobin, and obesity using multiple linear regression analyses, adjusted for age, sex, study site, race/ethnicity, T1D duration, body mass index, and pubertal status. Compared with controls, youth with T1D had higher IL-6 and fibrinogen levels at all levels of glycemia and obesity, and hsCRP levels were significantly higher in youth with T1D in the top three quartiles of glycated hemoglobin (> or = 7.2%) and among normal-weight subjects. Leptin was lower in youth with poor glycemic control. Higher hsCRP and fibrinogen were correlated with higher total and LDL cholesterol, and apolipoprotein B in youth with T1D, whereas higher fibrinogen was correlated with higher LDL and apolipoprotein B in controls.

Conclusions: T1D is characterized by excess inflammation, independent of adiposity and glycemic control. Even T1D youth in good glycemic control had higher levels of IL-6 and fibrinogen than controls. Elevated inflammatory markers were associated with an atherogenic lipid profile, which may contribute to accelerated atherosclerosis in youth with T1D.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anthropometry
  • Biomarkers
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Child
  • Cross-Sectional Studies
  • Diabetes Complications / blood
  • Diabetes Mellitus, Type 1 / blood*
  • Dyslipidemias / blood
  • Ethnic Groups
  • Female
  • Fibrinogen / metabolism
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / complications
  • Inflammation / blood*
  • Interleukin-6 / blood
  • Leptin / blood
  • Male
  • Obesity / blood
  • Obesity / complications
  • Puberty / physiology
  • Young Adult

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • Interleukin-6
  • Leptin
  • Fibrinogen
  • C-Reactive Protein