Abstract
The chronic complications of diabetes mellitus (DM) are accompanied by inflammatory manifestations. Our study aimed to evaluate a possible association between the inflammatory status (reflected by serum chitotriosidase and neopterin) and the timely evolution and occurrence of chronic microvascular complications in patients with type 1 DM. This observational, cross-sectional study included 82 type 1 DM patients from the Centre for Diabetes, Nutrition and Metabolic Diseases, Cluj-Napoca, Romania. Our results demonstrated a link between the extent of inflammation, evaluated by the enzymatic activity of circulating chitotriosidase, and the onset of microvascular complications, especially diabetic neuropathy and retinopathy. Chitotriosidase enzymatic activity showed an ascending evolution over time. In non-smoking patients, the increase in chitotriosidase activity was correlated with the extent of microalbuminuria and the decline of glomerular filtration rate, while in smokers, only the presence of a positive correlation between chitotriosidase activity and disease progression was noticed. According to our results, the time span between the moment of diagnosis and the onset of microvascular complications was longer in non-smokers than in smokers. These results also imply that increased chitotriosidase activity may be a predictor of endothelial dysfunction in type 1 DM.
Highlights
Diabetes mellitus (DM) is increasingly considered a major public healthcare problem.Currently, 463 million people worldwide are affected by this disease
Our study aimed to evaluate a possible association between the inflammatory status, reflected by circulating chitotriosidase and neopterin levels and the occurrence of chronic microvascular complications in patients with type 1 DM
Neuropathy was present in 58.54% and retinopathy in 60.98% of patients
Summary
463 million people worldwide are affected by this disease. Diabetes Federation (IDF) estimates that, by 2045, the number of patients with DM may reach 700 million. In Europe, the latest estimates show that 59.3 million people are affected, of whom 286.000 are children and adolescents (aged 0–19 years) with type 1 DM. In. Romania, the prevalence of this disease has reached 8.8%, with approximately 1 in 11 people being diagnosed with DM [1]. Chronic complications of DM affect multiple organs and systems and are largely responsible for the morbidity and mortality associated with this disease. The risk of chronic complications is directly proportional to the increased level of blood glucose, and their onset is usually detected after 10 years of persistent hyperglycaemia [2]. HbA1c is widely used as an indicator of glycaemic control within 2–3 months prior to the testing
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