Markers of Endothelial Dysfunction in Children With Type 1 Diabetes Mellitus

Objective: To assess the serum levels of markers of endothelial glycocalyx (EG) degradation in children with type 1 diabetes mellitus (T1DM), depending on the presence or absence of diabetic complications, in order to determine the severity of endothelial dysfunction (ED). Methods: A total of 60 children and adolescents were examined (median age 7 [3; 16] years), 30 of whom formed the main group (patients with T1DM; MG), while the other 30 were included in the control group (CG). Depending on the presence or absence of diabetic complications (neuro-, retinopathy, and nephropathy), patients from the MG were divided into two subgroups: those without complications (n=16) and those with complications (n=14). In all children, serum markers of EG degradation were determined by enzyme-linked immunosorbent assay: syndecan-1 (SDC1), syndecan-4 (SDC4), endocan-1 (EC1), heparan sulfate (HS), angiopoietin-1 (AP1), and hyaluronic acid (HA). Results: Four out of six studied markers of EGL degradation – SDC4, HS, AP1, and HA – were elevated in the serum of patients with MG compared with children in the CG. The concentrations of SDC1 and EC1 in patients with T1DM did not differ significantly from those in the control group. The highest serum levels of SDC1, SDC4, HS, and HA were found in patients with T1DM who had diabetic complications. No statistically significant differences were found in the increase in EC1 and AP1 concentrations between children with diabetic complications and apparently healthy children. Conclusion: High serum levels of SDC4, HS, AP1, and HA in children with T1DM indicate EG degradation and ED. Elevated concentrations of SDC1, SDC4, HS, and HA may serve as laboratory criteria for the presence of diabetic complications.