Oxidative stress in youth with type 1 diabetes: Not only a matter of gender, age, and glycemic control

Aims: We assessed whether oxidative stress (OS) is increased in children/adolescents with type 1 diabetes (T1D) compared to healthy peers. Moreover, we searched for OS predictors in the T1D population. Methods: We compared the concentration of serum derivatives of reactive oxygen metabolites (d-ROMs) in 412 children/adolescents with T1D (3.6-23.5 years old) to that of 138 healthy children/adolescents (1.2-19.2 years old) by ANOVA adjusted for age, gender, and BMI z-score (z-BMI). Applying a general linear model, in a subgroup of 331 patients using continuous glucose monitoring, we searched for predictors of d-ROMs among 3-day, 2-week, and 4-week metrics of glucose control and variability, such as mean blood glucose, percent time in range (70-180 mg/dl,TIR70-180), coefficient of variation, and others, as well as among conventional cardiovascular risk factors like current and average HbA1c, z-BMI, blood pressure percentiles, and lipid concentrations recorded retrospectively over the entire follow-up period. Results: D-ROMs levels were significantly higher in children/adolescents with T1D compared to controls [371.9 (64.2) versus 324.9 (46.3), p < 10(-16)]. Sex (B = 49.1, eta(2) = 0.14, p = 1.3 * 10(-9)), age < 12 years in boys (B = 79.4, eta(2) = 0.074, p = 10(-7)),3-day TIR70-180 (B =-0.87, eta(2) = 0.048, p = 6.5 * 10(-5)), and z-BMI (B = 7.4, eta(2) = 0.016, p = 0.022) predicted d-ROMs with an overall R-2 of 0.278. Conclusions: OS is increased in youth with T1D and only partially predicted by gender, age, glucose control, and anthropometry. Other potential determinants of OS in this population should be targeted in future studies. (C) 2021 Elsevier B.V. All rights reserved.