Transforming growth factor β1 at clinical onset of Type 1 diabetes mellitus. A pilot study

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Abstract
Aims The aims of the study were to determine whether transforming growth factor β1 TGF-β1 levels are raised at diagnosis of Type 1 diabetes mellitus and are related to blood glucose. Subjects and methods Fourteen patients (mean age 24.3 ± 4.9 years) admitted to hospital for onset of Type 1 diabetes were studied. On the first day of hospitalization, before insulin therapy, and at 1, 4 and 16 weeks, fasting blood glucose, HbA1c, lipid profile and TGF-β1 levels and TGF-β1 levels in 24-h urine were determined. The control group included 14 non-diabetic subjects with similar characteristics to those of the diabetic group. Results Plasma and urinary TGF-β1 levels were significantly lower in controls (4.7 (1.6–6.8) ng/ml P < 0.001; 5.7 (1.5–8.5) ng/mg urinary creatinine, P < 0.01) than in patients with Type 1 diabetes mellitus [10.5 (1.8–24.9) ng/ml; 10.1 (4.2–29.8) ng/mg urinary creatinine]. On study completion, HbA1c fell from 11.6 ± 2.0 to 5.4 ± 0.6% (P < 0.001). Improved metabolic control was not associated with changes in plasma (9.4 (2.6–19.5)/5.9 (1.6–21.5)/7.0 (2.3–30.2)/10.5 (1.8–24.9) ng/ml at baseline, 1, 4 and 16 weeks, respectively) or urinary (12.0 (4.7–29.5)/10.9 (1.5–20.5)/8.7 (4.3–16.9)/10.1 (4.2–29.8) ng/mg urinary creatinine) TGF-β1 levels. A statistically significant correlation was observed between plasma TGF-β1 and insulin dosage (U/kg/day) (r = 0.52, P = 0.037). Conclusions The increased TGF-β1 production observed herein was not modulated by glycaemic reduction and could be a response to immuno-inflammatory activation present at the onset of Type 1 diabetes.