Evaluation of the role of Adiponectin, Interleukin4, Interleukin-6, and Interleukin-13 in children with insulin dependent diabetes mellitus (type 1)

Insulin dependant diabetes mellitus (IDDM) is an immune mediated disease characterized by the selective destruction of insulin producing βcells in the pancreas, leading to insulin deficiency and hyperglycemia. Recent evidence favours primary role of cellular auto immunity and its humoral mediators in pathogenesis and follow-up of IDDM. An imbalance of pro-/anti-inflammatory cytokines may accelerate diabetic vascular complications. The aim of this study was to evaluate the role of some pro inflammatory cytokines as IL-4, IL-6, IL-13 as well as anti-inflammatory cytokines adiponectin in type one diabetes mellitus and their associations with body mass index (BMI), glycemic control and disease duration in children with IDDM. Twenty children with IDDM were examined, their mean age was 10.45 ± 0.92 and 10 other children were taken as controls. Full medical history, full clinical examination, anthropometric assessment, random blood sugar and HbAIc % were done in both group. IL-4, IL-6, IL-13, and adiponectin levels were measured by ELISA technique. The results of this study revealed that the levels of IL-4, IL-6, IL-13, and adiponectin showed statistically high significant increase in IDDM group(mean ± SD: 51.27±7.24, 15± 4.07, 13.25 ± 03.97 pg/ml and 14.45 ± 2.05 μ g/ml, respectively when compared with non-diabetic controls (20.9 ± 7.13, 6.0±2.25, 7.1 ± 2.04, pg/ml 7.73±2.34 μg/ml, respectively as p value < 0.001). A significant positive correlation between IL-4, IL-6, and IL-13 levels with BMI in diabetic children was obtained. Additionally, Adiponectin level significantly correlated with HbAIc%. However, a significant negative correlation was found between adiponectin level and body mass index in those children. Pro inflammatory and anti-inflammatory cytokine levels in children with IDDM are not affected by glucose level or disease duration except adiponectin which was affected by HbAIc%. From this, it could be concluded that aside from glycemic control, additional therapeutic measures against elevated pro inflammatory signals may be necessary for preventing vascular complications in children with IDDM. Additionally, the imbalance of pro-/anti-inflammatory cytokines and the increase in their levels is highly suggestive of the availability of these cytokines as non invasive indices to help in further examination of pathophysiology of 1DDM and in monitoring their interventions which may interfere with disease development and progression