Adipokines Associated With Clinical Course Alteration in Pediatric Patients With T1D

Altered serum levels of nicotinamide phosphoribosyltransferase (NAMPT), omentin-1, and caspase-cleaved cytokeratin 18 fragment M30 (CK-18) in children with type 1 diabetes (T1D) may signify metabolic differences that do not stabilize with insulin treatment, according to findings published in Journal of Pediatric Endocrinology and Metabolism.

Researchers compared serum concentrations of NAMPT, omentin-1, and CK-18 in 245 children with T1D with serum concentrations in 243 healthy, age-matched controls. Participants with T1D were culled from the Hospital for Children and Adolescents of the University of Leipzig, and participants in the control group were recruited from the Leipzig Research Center for Civilization Diseases child study. Patients with T1D were also compared among each other based on different disease durations.

NAMPT serum values were significantly higher in children with longstanding T1D (6.6 ± 11.4 ng/mL) compared with matched controls (1.9 ± 2.3 ng/mL). Omentin-1 serum concentrations were significantly higher in children with recent onset T1D (468.5 ± 158.7 ng/mL) than in matched controls (328.6 ± 116.6 ng/mL); children with longstanding T1D also had significantly elevated omentin-1 serum levels (367.1 ± 130.6 ng/mL) when compared with matched controls (296.5 ± 94.4 ng/mL). For CK-18, serum concentrations were significantly lower in children with recent onset T1D (166.2 ± 280.9 U/L) compared with matched controls (177.6 ± 104.0 U/L), and were also significantly lower in children with longstanding T1D (104.2 ± 48.3 U/L) compared with matched controls (153.6 ± 110.5 U/L).  

Despite being higher at onset and decreasing with treatment, NAMPT levels did not statistically improve in children with T1D during insulin treatment. Multiple stepwise regression analysis did suggest the considerable influence of blood glucose levels and body mass index standard deviation score on omentin-1 values in the same children. Researchers observed significantly elevated CK-18 concentrations only in children with T1D at onset when compared with children with T1D who had been in treatment for at least 10 years.

The results suggest that in children with T1D, NAMPT elevation might indicate chronic inflammation. Researchers also concluded that “increased omentin-1 values are associated with hyperglycemia and therefore could be viewed as a marker for disturbed glucose metabolism.” In addition, “lower CK-18 serum concentrations may exclude relevant liver cell damage especially in terms of [non-alcoholic fatty liver disease].”

Reference

Nurten E, Vogel M, Kapellen TM, et al. Omentin-1 and NAMPT serum concentrations are higher and CK-18 levels are lower in children and adolescents with type 1 diabetes when compared to healthy age, sex and BMI matched controls [published online September 4, 2018]. J Pediatr Endocrinol Metab. doi:10.1515/jpem-2018-0353