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Exp Clin Endocrinol Diabetes 2004; 112(7): 378-382
DOI: 10.1055/s-2004-821023
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Low Grade Inflammation in Juvenile Obesity and Type 1 Diabetes Associated with Early Signs of Atherosclerosis

H. Mangge1 , K. Schauenstein2 , L. Stroedter3 , A. Griesl1 , W. Maerz1 , M. Borkenstein4
  • 1Clinical Institute of Medical and Chemical Laboratory Diagnosis, Medical University of Graz, Austria
  • 2Institute of Pathophysiology, Medical University of Graz, Austria
  • 3Department of Pediatric Surgery, Medical University of Graz, Austria
  • 4Department of Pediatrics, Medical University of Graz, Austria
Further Information

Publication History

Received: March 11, 2003 First decision: June 16, 2003

Accepted: December 8, 2003

Publication Date:
07 July 2004 (online)

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Abstract

Background: Subclinical inflammation has been implicated in the initiation and/or progression of atherosclerosis. Diabetes mellitus and obesity are risk factors for atherosclerosis, and asymptomatic low grade inflammation occurs prior to overt vascular lesions in these patients. In contrast to adults, little information exists concerning low grade inflammation in young type 1 diabetes and juvenile obesity.

Aim: To investigate low grade inflammation and immune activation in juvenile diabetes mellitus and obesity.

Methods: hs-CRP, soluble interleukin-2 receptor (sIL-2R), C-peptide, insulin, cortisol, vitamin B12, folic acid, leptin, and homocysteine were determined in 148 patients with juvenile type 1 diabetes, 86 obese children and 142 normal weighted age-matched healthy controls. Intima-media thickness (IMT) and lumen diameter of both common carotid arteries (CCA) was measured by ultrasonography in 52 healthy pediatric controls, 10 diabetics, and 34 obese juveniles.

Results: Serum hs-CRP was significantly elevated in patients with type 1 diabetes (p < 0.0001), and obese children (p < 0.0001) as compared to the control group. The obese juveniles (p < 0.0001) and the diabetics (p < 0.0001) showed significantly increased values for IMT of CAAs. Levels of homocysteine, sIL-2R, insulin, cortisol, vitamin B12, and folic acid did not differ from the controls. The elevation of hs-CRP was more pronounced in obesity as compared to type 1 diabetes (p < 0.0001), and the hs-CRP values correlated significantly with body mass index standard deviation score (BMI-SDS) values. Furthermore, the IMT and the luminal diameter of CCAs showed significant correlations with BMI-SDS values.

Conclusion: A low grade inflammation as determined by serum hs-CRP is significantly increased in children with type 1 diabetes, and even more pronounced in apparently healthy juveniles with obesity. The increased IMT of CCAs strongly argues for an association between this low grade inflammation and early atherosclerotic vessel injury.

Key words

hs-CRP - juvenile obesity - juvenile type 1 diabetes

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Associate Professor M. D. Harald Mangge

Clinical Institute of Medical and Chemical Laboratory Diagnosis and Pediatric Rheumatology/Immunology
Medical University of Graz

Auenbruggerplatz 36

8036 Graz

Austria

Phone: + 4331638583340

Fax: + 43 31 63 85 26 19

Email: harald.mangge@uni-graz.at