Qingbo Xu, Yu Yang, Qiang Huang, Liling Xie, Yaqin Feng, Li Yang
{"title":"儿童1型糖尿病患者细胞外(血清)基质金属蛋白酶水平与糖尿病酮症酸中毒和脑水肿的关系","authors":"Qingbo Xu, Yu Yang, Qiang Huang, Liling Xie, Yaqin Feng, Li Yang","doi":"10.2147/DMSO.S507337","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes mellitus (T1DM) in children is associated with acute complications such as diabetic ketoacidosis (DKA) and the severe risk of diabetic ketoacidosis-related cerebral edema (DKACE). Matrix metalloproteinases (MMPs) are implicated in inflammation and tissue remodeling, potentially contributing to these complications. This study explores the role of MMPs as biomarkers in pediatric T1DM patients with DKA and DKACE.</p><p><strong>Methods: </strong>We conducted a systematic cross-sectional study at Jiangxi Children's Hospital, enrolling 56 pediatric patients with T1DM, categorized into three groups: T1DM without complications, DKA, and DKACE. Serum levels of MMP-2, MMP-3, and MMP-9 were measured through ELISA. Statistical analyses assessed correlations between MMPs, glucose metabolism, and inflammatory markers, evaluating potential biomarker utility in disease characterization.</p><p><strong>Results: </strong>MMP-3 and MMP-9 levels were significantly elevated in the DKACE group compared to the T1DM and DKA groups, exhibiting strong correlations with decreased pH and bicarbonate levels (both p < 0.001). MMP-2 levels were reduced in DKACE, correlating positively with pH and bicarbonate levels. Post-clinical improvement analyses demonstrated no significant differences in MMP levels between DKA and DKACE groups, suggesting stabilization post-treatment regardless of initial acidosis severity.</p><p><strong>Conclusion: </strong>The distinct patterns of MMP-3 and MMP-9 elevations in DKACE highlight their potential as biomarkers for identifying and monitoring severe DKA complications. The findings suggest these enzymes play a significant role in cerebral edema pathophysiology, making them viable targets for future therapeutic interventions.</p>","PeriodicalId":11116,"journal":{"name":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","volume":"18 ","pages":"819-830"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932032/pdf/","citationCount":"0","resultStr":"{\"title\":\"Extracellular(Serum) Levels of Matrix Metalloproteinases in Pediatric Type 1 Diabetes Mellitus and Association with Diabetic Ketoacidosis and Cerebral Edema.\",\"authors\":\"Qingbo Xu, Yu Yang, Qiang Huang, Liling Xie, Yaqin Feng, Li Yang\",\"doi\":\"10.2147/DMSO.S507337\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Type 1 diabetes mellitus (T1DM) in children is associated with acute complications such as diabetic ketoacidosis (DKA) and the severe risk of diabetic ketoacidosis-related cerebral edema (DKACE). Matrix metalloproteinases (MMPs) are implicated in inflammation and tissue remodeling, potentially contributing to these complications. This study explores the role of MMPs as biomarkers in pediatric T1DM patients with DKA and DKACE.</p><p><strong>Methods: </strong>We conducted a systematic cross-sectional study at Jiangxi Children's Hospital, enrolling 56 pediatric patients with T1DM, categorized into three groups: T1DM without complications, DKA, and DKACE. Serum levels of MMP-2, MMP-3, and MMP-9 were measured through ELISA. Statistical analyses assessed correlations between MMPs, glucose metabolism, and inflammatory markers, evaluating potential biomarker utility in disease characterization.</p><p><strong>Results: </strong>MMP-3 and MMP-9 levels were significantly elevated in the DKACE group compared to the T1DM and DKA groups, exhibiting strong correlations with decreased pH and bicarbonate levels (both p < 0.001). MMP-2 levels were reduced in DKACE, correlating positively with pH and bicarbonate levels. Post-clinical improvement analyses demonstrated no significant differences in MMP levels between DKA and DKACE groups, suggesting stabilization post-treatment regardless of initial acidosis severity.</p><p><strong>Conclusion: </strong>The distinct patterns of MMP-3 and MMP-9 elevations in DKACE highlight their potential as biomarkers for identifying and monitoring severe DKA complications. The findings suggest these enzymes play a significant role in cerebral edema pathophysiology, making them viable targets for future therapeutic interventions.</p>\",\"PeriodicalId\":11116,\"journal\":{\"name\":\"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy\",\"volume\":\"18 \",\"pages\":\"819-830\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932032/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/DMSO.S507337\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/DMSO.S507337","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Extracellular(Serum) Levels of Matrix Metalloproteinases in Pediatric Type 1 Diabetes Mellitus and Association with Diabetic Ketoacidosis and Cerebral Edema.
Background: Type 1 diabetes mellitus (T1DM) in children is associated with acute complications such as diabetic ketoacidosis (DKA) and the severe risk of diabetic ketoacidosis-related cerebral edema (DKACE). Matrix metalloproteinases (MMPs) are implicated in inflammation and tissue remodeling, potentially contributing to these complications. This study explores the role of MMPs as biomarkers in pediatric T1DM patients with DKA and DKACE.
Methods: We conducted a systematic cross-sectional study at Jiangxi Children's Hospital, enrolling 56 pediatric patients with T1DM, categorized into three groups: T1DM without complications, DKA, and DKACE. Serum levels of MMP-2, MMP-3, and MMP-9 were measured through ELISA. Statistical analyses assessed correlations between MMPs, glucose metabolism, and inflammatory markers, evaluating potential biomarker utility in disease characterization.
Results: MMP-3 and MMP-9 levels were significantly elevated in the DKACE group compared to the T1DM and DKA groups, exhibiting strong correlations with decreased pH and bicarbonate levels (both p < 0.001). MMP-2 levels were reduced in DKACE, correlating positively with pH and bicarbonate levels. Post-clinical improvement analyses demonstrated no significant differences in MMP levels between DKA and DKACE groups, suggesting stabilization post-treatment regardless of initial acidosis severity.
Conclusion: The distinct patterns of MMP-3 and MMP-9 elevations in DKACE highlight their potential as biomarkers for identifying and monitoring severe DKA complications. The findings suggest these enzymes play a significant role in cerebral edema pathophysiology, making them viable targets for future therapeutic interventions.
期刊介绍:
An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.