Role of Zinc and Advanced Glycation End Products in Children with Type 1 Diabetes Mellitus: Relation to Microvascular Complications

Abstract

Background: Zinc's role in enzymatic activities against oxidative stress may influence microvascular complications in young T1DM patients. Conversely, elevated AGE levels in pediatric T1DM correlate with oxidative stress, contributing to complications like retinopathy and nephropathy. Understanding the intricate interplay between zinc and AGEs holds promise for targeted interventions in disease management. Objectives: To assess the relationship between zinc, advanced glycation end products (AGEs), and microvascular complications in children with type 1 diabetes mellitus. Patients and methods: The study included 60 pediatric diabetic patients categorized into two groups based on microvascular complications into group A whom are diabetic patients with albuminuria either macro or micro albuminuria, group B whom are diabetic without albuminuria. A control group comprised 30 healthy children. Clinical examinations, BMI calculations, and biochemical analyses, including HbA1c, RBS, urine albumin/creatinine ratios, and serum zinc levels, were conducted. ELISA assays and colorimetric methods were employed for pentosidine and zinc assessments. Results: The study found significantly elevated Serum Pentosidine (4.94 ± 6.35 pg/ml) and decreased serum Zinc levels (23.25 ± 8.4 µg/dl) in cases compared to controls, with p-values of 0.0005 and <0.0001, respectively. Negative correlation (r = -0.718, p < 0.0001) existed between serum Zinc and Pentosidine. Diabetes duration, insulin dose, hospital admissions, and PICU admissions positively correlated with both Pentosidine and Zinc levels. Hb showed a significant negative correlation with Pentosidine (r = -0.734, p < 0.0001) and positive correlations with Zinc (r = 0.716, p < 0.0001). WBCs and RBS positively correlated with Pentosidine (r = 0.526, p = 0.0028; r = 0.848, p < 0.0001), while Plt and HbA1c showed no significant correlation. In Kidney Function Tests, serum urea correlated positively with Pentosidine (r = 0.387, p = 0.0344), and serum zinc showed a negative correlation with serum urea (r = -0.414, p = 0.023). The study highlighted intricate correlations between clinical and biochemical parameters, emphasizing the complex interplay in diabetic cases. Conclusion: In T1DM patients, weight and BMI trends reveal linkages to microvascular problems and changed body composition. T1DM without comorbidities had lower HbA1c and decreased kidney function, with macro and microalbuminuria indicating renal involvement. The complex relationship between serum pentosidine, zinc, and clinical indicators suggested T1DM microvascular problems. The results stress the need for rigorous surveillance and individualized treatment to understand the disease's complexity.

Keywords

• ages pentosidine type 1 dm
• zinc microvascular complications