Serum Apolipoprotein C3: A Link Between Diabetic Nephropathy and Subclinical Atherosclerosis in Children with Diabetes Mellitus

Abstract

Background: children with Diabetic nephropathy (DN) are at significant risk for morbidity and mortality mostly from cardiovascular disease. Apolipoprotein C3 (APOC3), a crucial regulator of plasma triglycerides, has developed lately as a potential predictor of cardiovascular events in individuals with diabetes. Therefore, the aim of this study was to use serum human APOC3 in children with type 1 diabetes to predict subclinical atherosclerosis and diabetic nephropathy early. Methods: a study of case control of 177 children divided into 3 groups, 59 each group. Group I, the health control group; group II, diabetics without nephropathy; and group III, diabetics with nephropathy, provided clinical and biochemical data. Serum levels of human apolipoprotein C3 and ultrasound of carotid intima media thickness (CIMT) were measured in all subjects. Results: There is a statistically significant difference between the studied groups regarding APOC3 (the difference is significant between each two groups) being the highest level in group III with a p value <0.001. There is a statistically significant positive correlation between APOC3 and mean CIMT. The best cutoff of APOC3 in prediction of atheromatous plaque among children with diabetic nephropathy is ≥33.6 with area under curve 0.829, with 88.6% sensitivity and 66.7% specificity and a statistically highly significant p value ≤0.001. Conclusion: APOC3 is a sensitive marker that not only reflects impaired lipid metabolism but also predicts the development of nephropathy and atherosclerosis in children with T1DM.