16 research outputs found
Increased Systemic Th17 Cytokines Are Associated with Diastolic Dysfunction in Children and Adolescents with Diabetic Ketoacidosis
Diastolic dysfunction suggestive of diabetic cardiomyopathy is established in children with T1DM, but its pathogenesis is not well understood. We studied the relationships of systemic inflammatory cytokines/chemokines and cardiac function in 17 children with T1DM during and after correction of diabetic ketoacidosis (DKA). Twenty seven of the 39 measured cytokines/chemokines were elevated at 6–12 hours into treatment of DKA compared to values after DKA resolution. Eight patients displayed at least one parameter of diastolic abnormality (DA) during acute DKA. Significant associations were present between nine of the cytokine/chemokine levels and the DA over time. Interestingly, four of these nine interactive cytokines (GM-CSF, G-CSF, IL-12p40, IL-17) are associated with a Th17 mediated cell response. Both the DA and CCL7 and IL-12p40, had independent associations with African American patients. Thus, we report occurrence of a systemic inflammatory response and the presence of cardiac diastolic dysfunction in a subset of young T1DM patients during acute DKA
Increased Systemic Th17 Cytokines Are Associated with Diastolic Dysfunction in Children and Adolescents with Diabetic Ketoacidosis
Diastolic dysfunction suggestive of diabetic cardiomyopathy is established in children with T1DM, but its pathogenesis is not well understood. We studied the relationships of systemic inflammatory cytokines/chemokines and cardiac function in 17 children with T1DM during and after correction of diabetic ketoacidosis (DKA). Twenty seven of the 39 measured cytokines/chemokines were elevated at 6–12 hours into treatment of DKA compared to values after DKA resolution. Eight patients displayed at least one parameter of diastolic abnormality (DA) during acute DKA. Significant associations were present between nine of the cytokine/chemokine levels and the DA over time. Interestingly, four of these nine interactive cytokines (GM-CSF, G-CSF, IL-12p40, IL-17) are associated with a Th17 mediated cell response. Both the DA and CCL7 and IL-12p40, had independent associations with African American patients. Thus, we report occurrence of a systemic inflammatory response and the presence of cardiac diastolic dysfunction in a subset of young T1DM patients during acute DKA
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Figure 9 shows mean DBP (mmHg) for groups DA or Non-DA across 19 time points.
<p>Age specific normal measurements are included as the last measurement on the X-axis.</p
Demographic data for 17 patients in data set.
*<p>Fisher's Exact chi-square analysis indicates a significant association between the Diastolic Abnormality and the African American race (p = 0.0319).</p
Figure 7 shows the linear regression plot for SBP-Non DA and DBP-Non DA over time.
<p>Mean age related normal valued is plotted in relation to patient SBP-Non DA/DBP-Non DA values for comparison.</p
a–i.
<p>*Identifies statistically significant (p<0.05) differences between DA and Non-DA groups for the same time point (5a–i). + identifies statistically significant (p<0.05) differences within DA or Non-DA groups across time points (5a–i). T1 (6–12 hrs post admission); T2 (2–3 wks); T3 (3 months).</p
Figure 2 shows that the difference in MDT at T2 minus T1 for the patients identified with mitral DA.
<p>The magnitude of the difference was statistically smaller (Z = −3.2684; p = 0.0011 : T1 not shorter than T2) in the DA group patients implying abnormal adaptation to sinus tachycardia at T1.</p
Comparative analysis for ECHO variables that had significant differences for all patients at T1 (6–12 hours post admission) vs T2 (2–3 weeks/ECHO baseline), (N = 17 patients).
*<p>Statistically significant results p<0.05.</p
Repeated Measures ANOVA results (F-ratio and probability) for cytokines with significant differences across time. T1 (6–12 hours post admission); T2 (2–3 weeks); T3 (3 months).
*<p>- Mean (T1) significantly different (p<0.05) from (T2) mean; ++ - Mean (T1) different (p<0.05) from mean cytokine baseline measurement (T3). N = 17 subjects.</p