Protective effect of vitamin A on residual pancreatic β cell function in children with type 1 diabetes mellitus
CHEN Yong-Xing, CHEN Qiong, ZHANG Ying-Xian, LIU Fang, YANG Hai-Hua, WU Sheng-Nan, WEI Hai-Yan
Department of Endocrinology and Inherited Metabolism, Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital/Zhengzhou Children's Hospital, Zhengzhou 450000, China
Abstract：Objective To study the protective effect of vitamin A on residual pancreatic β cell function in children with type 1 diabetes mellitus (T1DM) and its mechanism.Methods A total of 46 children with T1DM (with a course of disease of 0.5-1 year) were randomly divided into an intervention group and a non-intervention group (n=23 each). The children in both groups were given insulin treatment, and those in the intervention group were also given vitamin A at a daily dose of 1 500-2 000 IU. A total of 25 healthy children were enrolled as the control group. The daily dose of insulin was calculated for the children with T1DM, and the serum levels of glycosylated hemoglobin (HbA1C), stimulated C-peptide, vitamin A, and interleukin-17 (IL-17) were measured before intervention and 3 months after intervention.Results Before vitamin A intervention, the intervention group and the non-intervention group had a significantly lower serum level of vitamin A and a significantly higher level of IL-17 than the control group (P < 0.01). After 3 months of intervention, the intervention group had significantly lower serum IL-17 level and insulin dose and a significantly higher level of stimulated C-peptide than the non-intervention group (P < 0.05).Conclusions Vitamin A may protect residual pancreatic β cell function, possibly by improving the abnormal secretion of IL-17 in children with T1DM.
CHEN Yong-Xing,CHEN Qiong,ZHANG Ying-Xian et al. Protective effect of vitamin A on residual pancreatic β cell function in children with type 1 diabetes mellitus[J]. CJCP, 2018, 20(12): 1020-1023.
Steffes MW, Sibley S, Jackson M, et al. Beta-cell function and the development of diabetes-related complications in the diabetes control and complications trial[J]. Diabetes Care, 2003, 26(3):832-836.
[2]
Narendran P, Solomon TP, Kennedy A, et al. The time has come to test the beta cell preserving effects of exercise in patients with new onset type 1 diabetes[J]. Diabetologia, 2015, 58(1):10-18.
[3]
Haller MJ, Gitelman SE, Gottlieb PA, et al. Anti-thymocyte globulin/G-CSF treatment preserves β cell function in patients with established type 1 diabetes[J]. J Clin Invest, 2015, 125(1):448-455.
[4]
Alnek K, Kisand K, Heilman K, et al. Increased blood levels of growth factors, proinflammatory cytokines, and Th17 cytokines in patients with newly diagnosed type 1 diabetes[J]. PLoS One, 2015, 10(12):e0142976.
[5]
Bellemore SM, Nikoopour E, Krougly O, et al. Pathogenic T helper type 17 cells contribute to type 1 diabetes independently of interleukin-22[J]. Clin Exp Immunol, 2016, 183(3):380-388.
[6]
Yosaee S, Akbari Fakhrabadi M, Shidfar F. Positive evidence for vitamin A role in prevention of type 1 diabetes[J]. World J Diabetes, 2016, 7(9):177-188.
[7]
钱荣立. 关于糖尿病的新诊断标准与分型[J]. 中国糖尿病杂志, 2002, 8(1):5-6.
[8]
Zunino SJ, Storms DH, Stephensen CB. Diets rich in polyphenols and vitamin A inhibit the development of type I Autoimmune diabetes in nonobese diabetic mice[J]. J Nutr, 2007, 137(5):1216-1221.
[9]
Oram RA, Jones AG, Besser RE, et al. The majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells[J]. Diabetologia, 2014, 57(1):187-191.
Antonelli A, Fallahi P, Ferrari SM, et al. Serum Th1(CXCL10) and Th2(CCL2) chemokine levels in children with newly diagnosed type 1 diabetes:a longitudinal study[J]. Diabet Med, 2008, 25(11):1349-1353.
