BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) and pro-inflammatory cytokines have been suggested as sensitive markers of endothelial dysfunction. Our aim was to monitor plasma hs-CRP levels at different time-points and in different degrees of ketoacidosis severity, its association with cytokine levels and its role as a marker of severe ketoacidosis complications. PATIENTS AND METHODS: We studied in 38 newly diagnosed children with type 1 diabetes and ketoacidosis, aged 7.7 ± 3.1 years, hs-CRP, white blood cell count (WBC), and plasma levels of cytokines IL-1β (interleukin-1β), IL-2, IL-6, IL-8, IL-10, TNF-α (tumor necrosis factor-α) prior to and during DKA management. RESULTS: On admission, the levels of WBC, PMN, IL-6 and IL-10 were elevated, but were all reduced within 120 h after ketoacidosis management. In the group with moderate/severe ketoacidosis, but not in mild ketoacidosis, hs-CRP levels were significantly reduced at 24h (p=0.021), WBC and IL-6 at 120 h (p=0.003), while IL-10 was prematurely reduced at 6-8h (p=0.008). Moreover hs-CRP was significantly associated with WBC (p=0.023) and IL-6 (p=0.028) on admission, with IL-6 (p=0.002) and IL-8 (p=0.014) at 24h and with IL-10 (p=0.027) at 120 h. The above were not observed in the group with mild ketoacidosis. CONCLUSIONS: In the children with moderate/severe diabetic ketoacidosis of our study, increased levels of hs-CRP and IL-6 were observed, together with leukocytosis and neutrophilia, without the presence of infection. As hs-CRP was found to be strongly associated with the inflammatory IL-6, the prolonged elevation of hs-CRP levels in children with severe ketoacidosis could serve as a marker for the development of its severe complications.
BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) and pro-inflammatory cytokines have been suggested as sensitive markers of endothelial dysfunction. Our aim was to monitor plasma hs-CRP levels at different time-points and in different degrees of ketoacidosis severity, its association with cytokine levels and its role as a marker of severe ketoacidosis complications. PATIENTS AND METHODS: We studied in 38 newly diagnosed children with type 1 diabetes and ketoacidosis, aged 7.7 ± 3.1 years, hs-CRP, white blood cell count (WBC), and plasma levels of cytokines IL-1β (interleukin-1β), IL-2, IL-6, IL-8, IL-10, TNF-α (tumor necrosis factor-α) prior to and during DKA management. RESULTS: On admission, the levels of WBC, PMN, IL-6 and IL-10 were elevated, but were all reduced within 120 h after ketoacidosis management. In the group with moderate/severe ketoacidosis, but not in mild ketoacidosis, hs-CRP levels were significantly reduced at 24h (p=0.021), WBC and IL-6 at 120 h (p=0.003), while IL-10 was prematurely reduced at 6-8h (p=0.008). Moreover hs-CRP was significantly associated with WBC (p=0.023) and IL-6 (p=0.028) on admission, with IL-6 (p=0.002) and IL-8 (p=0.014) at 24h and with IL-10 (p=0.027) at 120 h. The above were not observed in the group with mild ketoacidosis. CONCLUSIONS: In the children with moderate/severe diabetic ketoacidosis of our study, increased levels of hs-CRP and IL-6 were observed, together with leukocytosis and neutrophilia, without the presence of infection. As hs-CRP was found to be strongly associated with the inflammatory IL-6, the prolonged elevation of hs-CRP levels in children with severe ketoacidosis could serve as a marker for the development of its severe complications.
Authors: Nikifor K Konstantinov; Mark Rohrscheib; Emmanuel I Agaba; Richard I Dorin; Glen H Murata; Antonios H Tzamaloukas Journal: World J Diabetes Date: 2015-07-25
Authors: Matthew D Campbell; Mark Walker; Michael I Trenell; Steven Luzio; Gareth Dunseath; Daniel Tuner; Richard M Bracken; Stephen C Bain; Mark Russell; Emma J Stevenson; Daniel J West Journal: PLoS One Date: 2014-05-23 Impact factor: 3.240
Authors: Robert Z Harms; Katie R Ostlund; Monina S Cabrera; Earline Edwards; Marisa Fisher; Nora Sarvetnick Journal: Front Immunol Date: 2020-09-15 Impact factor: 7.561