Serum Apelin: A New Marker of Early Atherosclerosis in Children with Type 1 Diabetes Mellitus

Rania N Sabry, Maged A El Wakeel, Ghada M El-Kassas, Ahmed F Amer, Wael H El Batal, Salwa Refat El-Zayat, Mohamed Abou-El-Asrar, Rania N Sabry, Maged A El Wakeel, Ghada M El-Kassas, Ahmed F Amer, Wael H El Batal, Salwa Refat El-Zayat, Mohamed Abou-El-Asrar

Abstract

Introduction: Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in children that may be complicated by micro or macrovascular complications. Measurement of the carotid intima-media thickness (CIMT) allows the early detection of atherosclerotic alterations of blood vessels that may complicate T1DM.

Subjects and methods: This study is a case-control study. Participants were classified into two groups. The first group included 40 children with T1DM and the second group included 30 matched healthy controls. The studied cases were recruited from Endocrinology and Diabetology Unit, Pediatric Hospital, Ain Shams University. Serum apelin, cholesterol, TG, LDL were measured for every case. Also, albumin level was analyzed in urine. Measurement of the carotid intima-media thickness (CIMT) was done for all cases.

Results: Comparison between T1DM patients and controls revealed that serum apelin, cholesterol, TG, LDL and albuminuria were significantly increased in cases compared to controls. Significant positive correlations were detected between HbA1C, albuminuria and lipid profile with apelin in the diabetic group (p < 0.05). CIMT has significant positive correlation with serum apelin levels (r = 0.36, p = 0.05). Also, this study found positive correlations between CIMT and some variables as LDL, SBP z-score and duration of the illness.

Conclusion: Increased levels of serum apelin in T1DM patients may be considered as predicting factor for the ongoing development of vascular sequels. This study highlighted the possible validity of apelin assay as an early predictor of atherosclerosis in T1DM children. Evaluating CIMT in these patients is of at most important for early detection of subclinical atherosclerosis.

Keywords: LDL; Serum apelin; TG; Type 1 diabetes mellitus; carotid intima-media thickness; case-control study; cholesterol.

Figures

Figure 1
Figure 1
Correlation between serum apelin levels and CIMT

References

    1. Giannini C, Mohn A, Chiarelli F, Kelnar CJ. Macrovascular angiopathy in children and adolescents with type 1 diabetes. Diabetes Metab Res Rev. 2011;27(5):436–60. . PMid:21433262.
    1. Cote AT, Harris KC, Panagiotopoulos C, Sandor GG, Devlin AM. Childhood obesity and cardiovascular dysfunction. J Am CollCardiol. 2013;62(15):1309–19. . PMid:23954339.
    1. El Wakeel MA, El-Kassas GM, Amer AF, Elbatal WH, Sabry RN, EL-Ghaffar Mohammed NA. E-selectin and vascular complications in children with Type 1 diabetes mellitus. Med Res J. 2014;13(1):27–32. .
    1. El Wakeel MA, Abou-el-asrar M, El-kassas GM, Elabd MA, Zeid DA, Sabry RN, Awadallah E. Urinary Markers of Oxidative DNA Damage in Type 1 Diabetic Children: Relation to Microvascular Complications. Asian J Pharm Clin Res. 2017;10(10):318–22. .
    1. Sheetz MJ, King GI. Molecular understanding of hyperglycemia's adverse effects for diabetic complications. JAMA. 2002;288(20):2579–88. .
    1. O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK, Jr, Cardiovascular health study collaborative research group Carotid artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med. 1999;340(1):14–22. . PMid:9878640.
    1. Manios E, Tsivgoulis G, Koroboki E, et al. Impact of prehypertension oncommon carotid artery intima-media thickness and left ventricular mass. Stroke. 2009;40:1515–8. . PMid:19164793.
    1. Fairbridge N.A, Southall T.M, Ayre D.C, Komatsu Y, Raquet P.I, Brown R.J, Randell E, Kovacs C.S, Christian S.L. Loss of CD24 in Mice Leads to Metabolic Dysfunctions and a Reduction in White Adipocyte Tissue. PLoS One. 2015:10. .
    1. Tatemoto K, Hosoya M, habata Y, et al. Isolation and characterization of a novel endogenous peptide ligand for the human APJ receptor. Biochem Biophys Res commun. 1998;251:471–6. . PMid:9792798.
    1. Habata Y, Fujii R, Hosoya M, Fukusumi S, Kawamata Y, Hinuma S, Kitada C, Nishizawa N, Murosaki S, Kurokawa T, Onda H, Tatemoto K, Fujino M. Apelin, the natural ligand of the orphan receptor APJ is abundantly secreted in the colostrum. Biochim Biophys Acta. 1999;1452:25–35. .
    1. Ladeiras-Lopes R, Ferreira-Martins J, Leite-Moreira AF. The apelinergic system: the role played in human physiology and pathology and potential therapeutic applications. Arq Bras Cardiol. 2008;90(5):343–9. PMid:18516406.
    1. Rittig K, Hildebrandt U, Thamer C, Staiger H, Peter A, Stefan N, Fritsche A, Häring HU, Balletshofer BM, Siegel-Axel D. Apelin serum levels are not associated with early atherosclerosis or fat distribution in young subjects with increased risk for type 2 diabetes. Exp Clin Endocrinol Diabetes. 2011;119(6):358–61. . PMid:21264801.
    1. Ma WY, Yu TY, Wei JN, Hung CS, Lin MS, Liao YJ, et al. Plasma apelin: a novel biomarker for predicting diabetes. Clin Chim Acta. 2014;435:18–23. . PMid:24721640.
    1. Yu S, Zhang Y, Li M.Z, Xu H, Wang Q, Song J, Lin P, Zhang L, Liu Q, Huang Q. X, Wang K, Hou W.K. Chemerin and apelin are positively correlated with inflammation in obese type 2 diabetic patients. Chin Med J (Engl) 2012;125:3440–3444.
    1. Attane C, Daviaud D, Dray C, et al. Apelin stimulates glucose uptake but not lipolysis in human adipose tissue ex vivo. J Mol Endocrinol. 2011;46:21–8. . PMid:21062936.
    1. Members of the WHO Multicenter Growth Reference Study Group (WMGRS) WHO child growth standards: length/height-forage, weight-for-age, weight-for-length, weight-for-height and body mass index for age: methods and development. WHO Press. WHO Child Growth Standards. Available in .
    1. Friedwald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.
    1. Showell PJ, Matters DJ, Long JM, Carr Smith HD, Bradwell AR. Evaluation of latex-enhanced nephelometric reagents for measuring free immunoglobulin light-chains on a modified MININEPHTM. Clin Chem. 2002;48(Suppl):A22, E.
    1. Comper WD, Osicka TM, Jerums G. High prevalence of immuno-unreactive intact albumin in urine of diabetic patients. Am J Kidney Dis. 2003;41:336–342. . PMid:12552494.
    1. DallaPozza R, Ehringer-Schetitska D, Fritsch P, Jokinen E, Petropoulos A, Oberhoffer R, Association for European Paediatric Cardiology Working Group Cardiovascular Prevention Intima media thickness measurement in children: A statement from the Association for European Paediatric Cardiology (AEPC) Working Group on Cardiovascular Prevention endorsed by the Association for European Paediatric Cardiology. Atherosclerosis. 2015;238(2):380–7. . PMid:25555270.
    1. Alexiadou K, Kokkinos A, Liatis S, Perrea D, Katsilambros N, Tentolouris N. Differences in plasma apelin and visfatin levels between patients with type 1 diabetes mellitus and healthy subjects and response after acute hyperglycemia and insulin administration. Hormones (Athens) 2012;11:444–450. .
    1. Habchi M, Duvillard L, Cottet V, Brindisi M C, Bouillet B, Beacco M, et al. Circulating apelin is increased in patients with type 1 or type 2 dia-betes and is associated with better glycaemic control. Clin Endocrinol (Oxf) 2014;81:696–701. . PMid:24417455.
    1. Dray C, Sakar Y, Vinel C, Daviaud D, Masri B, Garrigues L, et al. The intestinal glucose-apelin cycle controls carbohydrate absorption in mice. Gastroenterology. 2013;144:771–780. . PMid:23313268.
    1. Fin AV, Kolodgie VR. Correlation between carotid intima-media thickness and atherosclerosis: a point of view from pathology. Atheriscler Throm Vasc Biol. 2010;30:177–81. . PMid:19679833.
    1. Nascimento A, Sequeira I, Vasconcelos D, Gandolfi L, Pratesi R, Nóbrega Y. Endothelial dysfunction in children with type 1 diabetesmellitus. Arch Endocrinol Metab. 2017;260
    1. Guo C, Liu Y, Zhao W, Wei S, Zhang X, Wang W, Zeng X. Apelin promotes diabetic nephropathy by inducing podocyte dysfunction via inhibiting proteasome activities. J Cell Mol Med. 2015;19:2273–2285. PMid:26103809. PMCid: PMC4568931.
    1. Yue P, Jin H, Xu S, Aillaud M, Deng AC, Azuma J, et al. Apelin decreases lipolysis via Gq, Gi, and AMPK-Dependent mechanisms. Endocrinology. 2011;152:59–68. . PMid:21047945. PMCid: PMC3033059.
    1. Than A, Cheng Y, Foh LC, Leow MK, Lim SC, Chuah YJ, et al. Apelin inhibits adipogenesis and lipolysis through distinct molecular pathways. Mol. Cell. Endocrinol. 2012;362:227–241. . PMid:22842084.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する