The activity of N-acetyl-beta-d-glucosaminidase and tumor necrosis factor-alpha at early stage of diabetic retinopathy development in type 1 diabetes mellitus children

Objective: The assessment of the clinical significance of TNF-α, IL-10 and NAG with its A and B isoforms concentrations in children with DM type 1 for the detection of early stages of both diabetic retinopathy and nephropathy. Patients and methods: One hundred and two children with DM type 1 and 35 healthy controls were analyzed. Levels of TNF-α, IL10 and total NAG enzyme activity with its A and B isoforms were measured in serum and urine of all participants. Results: Children with diabetic retinopathy had a significantly higher levels of TNFα in serum (P = 0.01) in comparison to those without retinopathy. The activity of NAG (P = 0.002) and its isoform A (P = 0.006) and isoform B (P = 0.001) were significantly higher in children with diabetic retinopathy in comparison to those without this complication. Conversely, within the group with retinopathy, more children had detectable concentrations of IL10 in serum as compared to those without retinopathy (P = 0.01). Conclusions: These results suggest that NAG activity and TNF-α concentration in diabetic retinopathy patients might show a relationship with a degree of renal glomeruli epithelial cells and renal proximal tubules damage.