The aim — to study the role of myokines in the development of insulin resistance in children with type 1 diabetes mellitus.Materials and methods. Observations involved 68 children with type 1 diabetes mellitus (DM 1), with the mean age 11 to 17 years. Depending on the glycemic controllevel, patients were divided into 3 research groups. The control group consisted of 20 relatively healthy children. Muscle mass, the skeletal muscles index, fat mass and the percentage of fat in the bodywere determined in all patients. The Lovett’s test was used to assess the loss of muscle strength; evaluation of insulin resistance was made based onthe triglycerideglucose index (TYG). Levels of myostatin, irisin, interleukins 6 and 13were measured in blood serum.Results and discussion. It has been established that with deterioration in the level of glycemic controlin DM 1 children, the component redistribution of body composition took place with an increased fat mass proportionand decreased muscle mass. This resulted in the reduced insulin-mediatedabsorption of glucose, that was confirmed by the significant increase in TYG level compared to control group. The analysis of cytokines in the blood serum showed a significant increase in the level of myostatin and interleukin6 compared with the control group and the tendency to increased levels of the interleukins 13 and the level of irisin in the blood serum in pediatric patients with DM 1. The increased levels of myostatin in DM 1childrenassociated with an increase in the triglycerides content (r = 0.44, p < 0.05) and raised TYG index (r = 0.33, p < 0.05), testifying theclose correlation between the high myostatin levels and the development of insulin resistance.Conclusions. In children with diabetes mellitus, the reduction of muscle strength and muscle mass take place with a deterioration in the state of glycemic control, accompanying by the development of insulin resistance. The violation of myokines synthesis,along with the chronic hyperglycemia and diabetic myopathy, plays the leading role in the formation of insulin resistance in pediatric patients with DM 1. It is manifested by the increased production of myostatin and interleukin6 in the absence of activation of irisin and interleukin13synthesis.
MECHANISMS IN ENDOCRINOLOGY: Mechanisms and evaluation of bone fragility in type 1 diabetes mellitus
