ESPE Abstracts

Although type 1 diabetes (T1D) is most common autoimmune chronic metabolic disease in childhood, data about the role of T-Lymphocytes (T-Ly) and B-Lymphocytes (B-Ly) in children after the diabetes onset are still controversial. The aim of the study was to evaluate the serum levels of T– and B-Ly in children with T1D as a predisposing factor for genital candidiasis (GC).

Material: We studied 71 children with T1D at the age of 6 to 18 years, divided into two groups – with and without GC and 30 age-matched healthy controls.

Methods: A flow-cytometry immunophenotyping of T-Ly (CD3+), Ts (CD8+), Th (CD4+) and B-Ly (CD19+) was performed. Microbiological culture of genital discharge by the patients with T1D for diagnostic of GC was made. Glycated hemoglobin (HbA1c) for assessment of metabolic control of T1D was measured. Statistical analysis with Statgraph and SPSS software was performed and as statistical significant a P-value <0.05 was defined.

Results: Positive cultures for candidal infection of genitalia had 24 (33.8%) of 71 studied diabetic patients. The mean level of HbA1c showed a poor long term metabolic control in all researched T1D-patients – 10.09±2.28%, significantly higher in the group with GC – 11.09±2.26% than those without infection – 9.39±2.18% (P=0.0002). Serum levels of CD3+, CD4+ and CD8+ in all patients with T1D were found within the lower part of the normal reference range. No statistical significance with the control group was established (P>0.05). Serum levels of B-Ly 11,02% (P₂₅ 8,83; P₇₅ 13,85) in all diabetic children were significantly lower than those in heathy controls 14.52% (P₂₅ 12,23; P₇₅ 17,76) (P=0.001). We found no significant differences between the researched T- and B-Ly levels in diabetic children with and without Candida. Although the increased mean level of HbA1c in the studied patients, no significant correlation between the immunological parameters and metabolic control was found.

Conclusion: In the researched children with T1D was found poor long term metabolic control. Their T-Ly levels were distributed at the lower reference range and B-Ly were decreased, with no significant differences in association with Candida infection.