Stratification of controlled course of autoimmune diabetes mellitus as a low-level inflammation in children

Abaturov, A.E. and Nikulina, A.А. and Petrenko, L.L. and Sova, D.Yu. (2020) Stratification of controlled course of autoimmune diabetes mellitus as a low-level inflammation in children. Topical issues of the development of modern science. Abstracts of the 6th International scientific and practical conference. pp. 15-21.

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Abstract

Introduction. Diabetes mellitus (DM) in children - a chronic pathology that requires constant medical attention due to the labile course, the complexity of the treatment, a tendency to developing autoimmune processes, complications and disability. Objective: to identify predictors of controlled course of autoimmune diabetes in children for predicting its occurrence. Materials and methods: among 100 children with first diagnosed type 1 diabetes aged from 1 to 18 years was confirmed autoimmune diabetes in 98 children by determining the level of antibodies to glutamic acid decarboxylase, tyrosine phosphatase (islet antigen-2), zinc transporters, by enzyme immunoassay (ELISA, «Euroimmun»). Using sequential analysis of Wald, was analyzed 100 clinical - immunological, molecular - genetic, instrumental - diagnostic parameters determining relative risk (RR) and diagnostic coefficient (DC) in patients with uncontrolled (study group, n=23) and controlled course (control group, n=31) of autoimmune diabetes. Results. Predictors of controlled course of autoimmune diabetes in children were selected 14 factors sufficiently informative prognostic significance (I≥0,5), which are suitable to use in clinical practice: the level of glycated hemoglobin less than 9% after 1 year of observation (I=5.4), transferred flu 1 year before debut of DM (I=1.58), no increase in antibodies to glutamic acid decarboxylase (I=1.2), alanine aminotransferase level more than 39.3 U/l (I=1.18), age of manifestation of the disease 4-6 years (I=1.02), alkaline phosphatase level less than 328 U/l (I=0.76), maximum glycemia less than 23 mmol/l (I=0.64), weight at birth less than 4 kg (I=0.63), the level of urea less than 4.3 mmol/L in the blood (I=0.61), related autoimmune diseases (I=0.56), concomitant cardiovascular pathology (I=0.56), hypoproteinemia less than 60 g/dL (I=0.55), observance of hourly diet in the first year of life (I=0.54), the absence of glycosuria (I=0.54). Conclusion: to improve the quality of diagnosis, prognosis and personalized treatment of autoimmune diabetes mellitus, especially in patients with first diagnosed disease, is necessary to define specific autoantibodies against islet apparatus of the pancreas, a, namely, the study of the level of antibodies to glutamic acid decarboxylase.

Item Type: Article
Additional Information: The 6th International scientific and practical conference “Topical issues of the development of modern science” (February 12-14, 2020) Publishing House “ACCENT”, Sofia, Bulgaria. 2020. 1018 p. 7. URL: http://sci-conf.com.ua.
Uncontrolled Keywords: autoimmune diabetes, children, prognosis, predictors, Wald analysis
Subjects: Pediatrics
Divisions: Departments > Department of Pediatrics 1 and medical genetics (formerly - Faculty Pediatrics and Medical Genetics)
Depositing User: Елена Шрамко
Date Deposited: 03 Apr 2020 11:26
Last Modified: 03 Apr 2020 11:28
URI: http://repo.dma.dp.ua/id/eprint/5216

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