Key result
Adolescent type 1 diabetes links to elevated inflammatory biomarkers, particularly TNF-α in large fibre neuropathy.
Why the study?
To investigate circulating inflammatory markers in adolescents with type 1 diabetes with and without different neuropathies, and evaluate associations with nerve function and clinical parameters.
Cross-Sectional (n=79)
Yes
Adolescents with type 1 diabetes exhibit increased low-grade inflammation, with TNF-alpha levels correlating with large fibre neuropathy and reduced nerve conduction velocity.
May link low-grade inflammation to neuropathy in type 1 diabetes adolescents; hypothesis-generating and should not yet change practice.
OBJECTIVES: The aims of this study were to investigate circulating levels of inflammatory markers in adolescents with type 1 diabetes with and without different types of neuropathies and evaluate the association between inflammatory biomarkers, nerve function and clinical parameters. DESIGN: Cross-sectional study. SETTING: Hospitals and Steno Diabetes Center in Denmark. PARTICIPANTS: Adolescents with more than 5 years of diabetes duration were investigated for large fibre, small fibre and autonomic neuropathy as a part of the T1DANES study. Blood samples from the participants were analysed for inflammatory biomarkers by Meso Scale Discovery multiplexing technology. PRIMARY AND SECONDARY OUTCOME MEASURES: Inflammatory biomarkers and results of diagnostic nerve tests. RESULTS: Fifty-six adolescents with type 1 diabetes and 23 healthy controls were included. The adolescents with diabetes had significantly higher interferon-gamma, tumour necrosis factor-alpha (TNF-a), interleukin (IL)-10 and soluble urokinase plasminogen activator receptor (suPAR) compared with healthy controls (p values<0.05). TNF-a was higher in the adolescents with large fibre neuropathy (LFN) (p=0.03) compared with those without LFN in the group with diabetes. A negative correlation was seen between TNF-a and conduction velocity in nervus tibialis (p=0.04), and higher TNF-a and IL-6 were associated with higher gastric motility index (TNF-a, p value=0.03; IL-6, p value=0.02). There were no significant associations between inflammatory markers and expressed symptoms, haemoglobin A1c, diabetes duration or body mass index standard derivation score (p values>0.05). The receiver operating characteristic (ROC) curves for the inflammatory markers suggested them as poor screening methods for all types of neuropathies with an area under the curve between 0.47 and 0.67. CONCLUSION: Our results confirm increased low-grade inflammation in adolescents with type 1 diabetes. TNF-a was higher in adolescents with LFN and correlated negatively with nervus tibialis conduction velocity. The other inflammatory biomarkers fail to support differences in those with and without different types of diabetic neuropathies. However, TNF-a and IL-6 were positively correlated to gastric motility index.
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Rasmussen et al. (2023) conducted a cross-sectional in Type 1 diabetes (n=79). Type 1 diabetes vs. Healthy controls was evaluated on Inflammatory biomarkers and results of diagnostic nerve tests (p=<0.05). Adolescents with type 1 diabetes had significantly higher inflammatory biomarkers than healthy controls (P<0.05), and TNF-α was higher in those with large fibre neuropathy (P=0.03).
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