Inflammatory Markers in Obese Adolescents with Type 2 Diabetes and Their Relationship to Hepatokines and Adipokines - 25/05/16

Doi : 10.1016/j.jpeds.2016.02.055

Thomas Reinehr, MD ^1,^⁎ , Beate Karges, MD ², Thomas Meissner, MD ³, Susanna Wiegand, MD ⁴, Birgit Stoffel-Wagner, MD ⁵, Reinhard W. Holl, MD ^6,^{^{∗
Contributed equally.}}, Joachim Woelfle, MD ^7,^{^{∗
Contributed equally.}}
¹ Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Germany
² Medical Faculty, Division of Endocrinology and Diabetes, German Center for Diabetes Research (DZD), Rheinisch-Westfälische Technische Hochschule Aachen University, Germany
³ Department of General Pediatrics, Neonatology and Pediatric Cardiology, German Center for Diabetes Research (DZD), University Children's Hospital Düsseldorf, Germany
⁴ Department of Pediatric Endocrinology and Diabetes, Charité Children's Hospital Universitätsmedizin Berlin, Germany
⁵ Department of Clinical Chemistry and Clinical Pharmacology, University Hospital of Bonn, Germany
⁶ Institute of Epidemiology and Medical Biometry, Zentralinstitut für Biomedizinische Technik, German Center for Diabetes Research (DZD), University of Ulm, Germany
⁷ Pediatric Endocrinology Division, Children's Hospital, University of Bonn, Germany

^∗Reprint requests: Thomas Reinehr, MD, Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Dr F Steiner Str 5, D-45711 Datteln, Germany.Department of Pediatric Endocrinology, Diabetes and Nutrition MedicineVestische Hospital for Children and Adolescents DattelnUniversity of Witten/HerdeckeDr F Steiner Str 5DattelnD-45711Germany

Abstract

Objectives

To analyze inflammatory markers, adipokines, and hepatokines in obese adolescents with and without type 2 diabetes mellitus (T2DM).

Study design

We studied high sensitivity C-reactive protein (hsCRP), tumor necrosis factor (TNF)-α, interleukin-1β, and interferon-γ, the hepatokines (fetuin-A and fibroblast growth factor [FGF]-21), and the adipokines (adiponectin and leptin) in a cross-sectional study of 74 predominately Caucasian adolescents with T2DM aged 12-18 years and in 74 body mass index (BMI)-, age–, and sex-matched controls.

Results

Adolescents with T2DM had significantly higher concentrations of hsCRP, TNF-α, and interleukin-1β compared with obese controls without T2DM. Interferon-γ was not detectable in obese adolescents with or without T2DM. In multiple linear regression analysis, hsCRP was significantly associated with FGF-21 and BMI, but not with hemoglobin A1c, adiponectin, leptin, fetuin-A, sex, or age. TNF-α was significantly related negatively to leptin, positively to BMI, but not to hemoglobin A1c, adiponectin, fetuin-A, FGF-21 sex, or age in multiple linear regression analysis.

Conclusions

Increased inflammatory markers are associated with T2DM in adolescents. Because hsCRP was related to FGF-21 and TNF-α was associated with leptin, these findings suggest a link between increased levels of these adipokines and hepatokines and chronic inflammation. Future longitudinal studies in humans are necessary to confirm these hypotheses.

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Keywords : hsCRP, TNFalpha, fetuin, FGF21, leptin, adiponectin, obesity, adolescents, type 2 diabetes mellitus

Abbreviations : BMI, CRP, FGF, Hb, hsCRP, IFN, IL, T2DM, TNF

Plan

Supported by the German Ministry of Education and Research within the German Competence Net Diabetes Mellitus (01 GI 1106), which is integrated into the German Center for Diabetes Research as of January 2015; the European Foundation for the Study of Diabetes; and the German Competence Net Obesity (01 GI 1130). The authors declare no conflicts of interest.

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Vol 173

P. 131-135 - juin 2016 Retour au numéro

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Inflammatory Markers in Obese Adolescents with Type 2 Diabetes and Their Relationship to Hepatokines and Adipokines - 25/05/16

Abstract

Objectives

Study design

Results

Conclusions

Plan

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