Soluble urokinase plasminogen activator receptor in type 1 diabetic children, relation to vascular complications

• Published in: Journal of diabetes and its complications Vol. 33; no. 9; pp. 628 - 633
• Main Authors: Sherif, Eman Mounir, El Maksood, Abeer Ahmed Abd, Youssef, Omneya Ibrahim, Salah El-Din, Nouran Yousef, Khater, Ola Khaled Mohamed
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2019; Elsevier Limited
• Subjects: Age; Blood pressure; Body mass index; Cardiovascular disease; Cell growth; Cholesterol; Data collection; Diabetes; Diabetic nephropathy; Diabetic retinopathy; Family medical history; Inflammation; Laboratories; Nephropathy; Neuropathy; Pediatrics; Peripheral neuropathy; Retinopathy; Soluble urokinase plasminogen activator; Triglycerides; Tumor necrosis factor-TNF; Type 1 diabetes; Urine; France; Germany; Nephropathy; Retinopathy; Neuropathy; Soluble urokinase plasminogen activator; Type 1 diabetes
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2019.06.001

Endothelial dysfunction caused by chronic inflammation is the cornerstone of vascular complications in type 1 Diabetes-Mellitus (T1DM). Soluble Urokinase Plasminogen Activator Receptor (SuPAR) is a novel marker of inflammation and endothelial dysfunction. To evaluate SuPAR in T1DM children and correlate it to diabetic vascular complications. Seventy T1DM children and 40 matched healthy controls were studied focusing on disease duration, insulin therapy and symptoms of diabetic complications. Blood-pressure, fundus and screening for peripheral-neuropathy were done. Fasting lipid profile, fraction-C of glycosylated hemoglobin (HbA1c%), Urinary albumin excretion (UAE), estimated-glomerular filtration rate (eGFR) and SuPAR were measured. Internal aortic diameter was measured with calculation of aortic distensibility and stiffness index. Sixteen T1DM patients(22.9%) had peripheral neuropathy, 12(17%) had nephropathy and none had retinopathy. SuPAR was significantly elevated in diabetic nephropathy (p < 0.01) and neuropathy (p < 0.01). Aortic stiffness index was significantly higher (p < 0.01) whereas, aortic strain and distensibility were significantly lower (p < 0.01) in T1DM than controls. SuPAR was significantly correlated to disease duration (p < 0.01), systolic blood pressure (p < 0.01), total cholesterol (p < 0.01), triglycerides (p < 0.01), UAER (p < 0.01) and aortic strain (0.013). Increased SuPAR early in diabetes might become a useful indicator of developing vascular complications. Further prospective studies are needed to determine the cut-off level of SuPAR for detection of T1DM and its complications.