Role of Vitamin D in Premature Atherosclerosis in Adolescents Type 1 Diabetes through Transforming Growth Factor-β1, Interferon-γ, Interleukin-10, and Interleukin-17

Haryudi Aji Cahyono; Wisnu Barlianto; Dian Handayani; Handono Kalim

doi:10.3889/oamjms.2020.4619

Authors

Haryudi Aji Cahyono Doctoral Program of Medical Science, Faculty of Medicine Universitas Brawijaya, Malang, Indonesia; Saiful Anwar Hospital, Malang, Indonesia; Department of Pediatric, Faculty of Medicine Universitas, Brawijaya, Malang, Indonesia
Wisnu Barlianto Saiful Anwar Hospital, Malang, Indonesia; Department of Pediatric, Faculty of Medicine Universitas, Brawijaya, Malang, Indonesia
Dian Handayani Nutrition Science Program, Medical Faculty, Universitas Brawijaya, Malang, Indonesia
Handono Kalim Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.4619

Keywords:

Cytokine, Premature atherosclerosis, Type 1 diabetes, Vitamin D

Abstract

BACKGROUND: Cardiovascular disease (CVD) is one the cause of mortality in patients with type 1 diabetes (T1D). The development of CVD is mainly triggered by atherosclerosis, which is associated with the inflammatory process.

AIM: The current study was aimed to investigate the association of Vitamin D level and premature atherosclerosis in adolescents with T1D, mainly through the regulation of various cytokines (interferon-γ [IFN-γ], IL-17, interleukin-10 [IL-10], and transforming growth factor-β1 [TGF-β1]).

METHODS: This study was designed as a cross-sectional study involving 40 T1D and 40 healthy control who came to the outpatient clinic, Saiful Anwar Hospital, Malang, Indonesia, within the study period (January 2019-July 2019).

RESULTS: Our data demonstrated that the IFN-γ and IL-17 levels were significantly higher (p < 0.001), whereas the TGF-β1 and IL-10 levels were significantly lower (p < 0.001) in T1D group compared with control. Furthermore, T1D also has higher carotid intima-media thickness (cIMT) value and lower flow-mediated dilatation (FMD) value compared to the control group (p < 0.001). Level of 25(OH)D3 was strongly associated with reduced cIMT and elevated FMD (p < 0.005). The direct effect of 25(OH)D3 on cIMT and FMD was higher than the indirect effect of Vitamin D through TGF-β1, IL-10, IL-17, and IFN-γ. The cutoff value of 25(OH)D3 levels for the risk of atherosclerosis was 12.8 ng/dL (sensitivity 85.7% and specificity 86.7%).

CONCLUSION: The level of Vitamin D in the T1D group was significantly lower than those in healthy children and Vitamin D deficiency substantially influences the formation of premature atherosclerosis.

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