Serum protease inhibitor concentrations and total antitrypsin activity in diabetic and non-diabetic children during adolescence
Serum protease inhibitor concentrations and total antitrypsin activity in diabetic and non-diabetic children during adolescence
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DOI：
10.1007/s00592-006-0220-8
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发表时间：
2006-12-01
影响因子：
3.8
通讯作者：
Kadziela, K.
中科院分区：
文献类型：
--
作者：
Lisowska-Myjak, B.;Pachecka, J.;Kadziela, K.
本研究的目的是评估三种主要的蛋白水解酶抑制剂：α-L-抗胰蛋白酶(AAT)、α-2-巨球蛋白(α-2-M)和抗凝血酶-III(AT-III)在青春期糖尿病和非糖尿病儿童血清中的浓度和相互关系，以及总的胰酶抑制能力(TIC)。49例1型糖尿病儿童(女24例，男25例)和24例非糖尿病儿童(女13例，男11例)按Tanner量表分为青春期前、青春期前后和青春期后3组。AAT、α-2-M和AT-III的测定采用Nor-Partigen平板放射免疫扩散法(Dade-Behring)，TIC的测定采用Bapna底物法。糖尿病儿童血清AAT[1.55g/L，1.40(95%可信区间，1.42~1.68)]和TIC[10.6 mg胰酶/100ml，10.3(95%CI，9.5~11.7)]均低于AAT[1.81g/L，1.60(95%CI 1.55~2.07)]和TIC[12.5 mg胰酶/100ml，13.2(95%CI，10.9-14.1)]。Tanner组之间的变量比较显示，糖尿病儿童的AAT浓度呈上升趋势，而非糖尿病受试者的TIC呈下降趋势。与青春期前和青春期前相比，在青春期后，无论是糖尿病患者还是非糖尿病患者，都没有发现研究参数之间的相关性。研究发现，高血糖和糖尿病病程与α-2-M和AT-III浓度显著相关，但与AAT血清浓度无关。与非糖尿病儿童相比，青春期糖尿病儿童的血清蛋白水解酶抑制物的浓度和相关性受到干扰。考虑到血清胰酶抑制物变化和蛋白酶-抗蛋白酶失衡引起的血管并发症的不利后果，糖尿病儿童在青春期发生这种情况的风险更大。
The aim of the study was the assessment of the concentrations and establishment of mutual relationships between three main protease inhibitors: alpha-l-antitrypsin (AAT), alpha-2-macroglobulin (alpha-2-M) and antithrombin-III (AT-III), and of the total trypsin inhibitory capacity (TIC) in the serum of diabetic and non-diabetic children during adolescence. Forty-nine children (24 girls and 25 boys) with type 1 diabetes mellitus and 24 non-diabetic children (13 girls and 11 boys) were divided according to the Tanner scale into three groups: pre-, peri- and post-pubertal. The concentrations of AAT, alpha-2-M and AT-III were determined by the radial immunodiffusion method on NOR-Partigen plates (Dade-Behring), while TIC was determined by the method using BAPNA as substrate. Means and medians of serum AAT [1.55 g/l, 1.40 (95% confidence interval, 1.42-1.68), respectively] and TIC [10.6 mg trypsin/100 ml, 10.3 (95% CI, 9.5-11.7)] in diabetic children were lower than means and medians of AAT [1.81 g/l, 1.60 (95% CI 1.55-2.07), respectively] and TIC [12.5 mg trypsin/100 ml, 13.2 (95% CI, 10.9-14.1)] in non-diabetic children. A comparison of variables between Tanner groups shows an increasing trend of AAT concentration in diabetic children and a decreasing trend of TIC in non-diabetic subjects. In contrast to pre- and peri-puberty, no correlations were found in the postpubertal period between the studied parameters, either in diabetic or non-diabetic patients. Hyperglycaemia and the duration of diabetes were found to have a significant association with alpha-2-M and AT-III concentrations, but not with AAT serum concentrations. The concentrations and correlations between serum protease inhibitors in diabetic children during adolescence are disrupted compared with non-diabetic children. Taking into account the unfavourable consequences of vascular complications resulting from serum trypsin inhibitor changes and protease-antiprotease imbalance, diabetic children are at greater risk of this occurring during adolescence.