Evaluation of Serum Soluble Cd40l as Marker of Nephropathy in Type 1 Diabetic Children and Adolescents | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 18, Volume 100, Issue 1, July 2025, Page 2645-2655 PDF (495.02 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.436785 | ||||
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| Abstract | ||||
| Background: Diabetes is a prevalent disease, with increasing incidence in young individuals. Diabetic nephropathy (DN), a critical and potentially reversible complication if detected early, necessitates the identification of ideal early predictors. The interaction between CD40 and its soluble ligand (sCD40L) may play a key role in the vascular inflammation that initiates diabetic microangiopathy. Objective: This study aimed to evaluate the potential of serum soluble CD40L for the early detection of kidney involvement in children and adolescents with type 1 diabetes. The goal was to enable timely intervention to prevent further complications and facilitate treatment if possible. Patients and methods: Ninety children and adolescents (47 females, 43 males with mean age of 14.73 ± 1.7 years, mean diabetes duration of 7.2 ± 2.5 years and 60 with T1DM) were included. Participants underwent comprehensive evaluations, including medical history, clinical examination, microalbuminuria assessment (urine albumin/creatinine ratio), and serum sCD40L level measurements using ELISA. Results: There was a highly significant increase in sCD40L levels in both the microalbuminuric and normo-albuminuric diabetic groups compared to the control group (p < 0.001). Notably, sCD40L levels were significantly higher in the microalbuminuric group compared to the normo-albuminuric and control groups (median 1.40 ± 0.9 ng/mL vs. 0.83 ± 0.09 ng/mL, p < 0.001). Additionally, the microalbuminuric group exhibited significantly increased levels of FBS, HbA1c, SGOT, and SGPT (p < 0.001, p = 0.002). Conclusion: The increased serum sCD40L levels seen in children and adolescents with T1DM, especially those with microalbuminuria, and its positive correlation with the duration of diabetes, urinary albumin excretion, and glycemic control suggest that sCD40L may be involved in diabetic vasculopathy in this age group. This study emphasized sCD40L's potential as a promising marker for diabetic nephropathy. | ||||
| Keywords | ||||
| T1DM; SCD40L; DN; MA; Risk factors | ||||
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