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The Aim: of this study was the evaluation of some factors having an influence on post-exercise albuminuria level in children with newly diagnosed type 1 diabetes as a prognostic factor of developing nephropathy., Material and Methods: 24 newly diagnosed type 1 diabetic children, aged 5.5-16.9 years, mean 10.2+/-3.2, were examined. In order to provoke albuminuria the patients underwent standardized exercise test using treadmill ramp according to the Bruce protocol. Pre- and post-exercise albuminuria and C-peptide levels by radioimmunoassay were evaluated. In urine of patients the albumin / creatinine ratio (ACR) was determined., Results: the tendency towards an increase in ACR ratio in children after exercise (10.5 mg/g (4-27.5) in comparison to the value in pre-exercise urine (7 mg/g (2.5-13), p=0.17) was observed. In 67% of patients (16/24) the ACR ratio was higher in post-exercise urine. In 25% of children (6/24) the ACR ratio was above 30 mg/g which was considered as post-exercise microalbuminuria. Next, parameters of metabolic control of type 1 diabetes were compared between patients with and without post-exercise microalbuminuria. No differences in the serum glucose, HbA1c, BMI, triglycerides, total cholesterol, insulin dose, frequency of ketoacidosis and C-peptide level between these groups of children were noted., Conclusions: we concluded that the post-exercise microalbuminuria as a marker of diabetic nephropathy risk may be observed in some patients already at the clinical onset of type 1 diabetes but further evaluation is needed to verify this hypothesis.

Unlabelled: Polymorphism of genes encoding glutathione S-transferases GSTM1, GSTT1 GSTP1 is one of the genetic predictors of susceptibility to cancers in the adults. The frequency of deletions of GSTM1. GSTT1 genes and transition A-G in GSTP1 gene were taken into consideration. THE AIM of this study was to investigate the role of GST genes polymorphisms as a genetic risk factor for acute lymphoblastic leukaemia (ALL), and to study the relationship of these polymorphisms with clinical outcome in childhood leukaemias., Material and Methods: 86 children with newly diagnosed acute leukaemia (female: male ratio = 37:49. median age = 7.8 years) and 460 healthy controls were examined using the PCR and PCR-RFLP methods to identify polymorphisms within GSTM1, GSTT1 and GSTP1 genes. In the group of children with ALL. the frequency of relapses, deaths, clinical course, immunophenotype of blasts and the initial response to prednisone were also analyzed., Results: the higher frequency of A-G transition in the GSTP1 gene was identified in the group of children with ALL in comparison to healthy controls (OR=3.13, 95%CI=1.4-7). We also found that the combination of GSTPl (Val/Val) and GSTM1 null genotypes further increased the risk of ALL (OR= 10.63, 95%CI=3.47 - 32.58; p =0.0001). No differences in the frequency of GSTM1 and GSTTI genes between both groups (OR=1; 95%CI=0,59-1,74 and OR=0, 71; 95%CI=0.45-1.13 respectively) were observed. Statistical analysis has not revealed any connections between polymorphisms within glutathione S-transferases genes and the frequency of relapses and death or poor initial response to prednisone. However, the biphenotypic immunophenotype or B-line blasts were the risk factors of relapse or death of progression in ALL (p=0.03)., Conclusion: transition in exon 5 of GSTP1 gene (alone or combined with GSTM1 deletion) may be one of the molecular predictors of higher susceptibility to acute leukaemia in children. but not of the clinical course of this disease.

The aim of this study was to estimate insulin resistance in newly diagnosed type 1 diabetic children and adolescents and to analyse the correlation between insulin secretion and impaired insulin action. 37 patients with type 1 diabetes mellitus aged 12.9 +/- 3 years were included in the study. Duration of diabetes was 6 months. Euglycemic-hyperinsulinemic clamp was performed to estimate insulin resistance. Glucose disposal rate was calculated as index M - mg/kg/min. Insulin secretion was measured by glucagon test. The serum level of cholesterol, HDL-Ch, triglycerides and HbA1 was examined. The height, weight, skinfold, waist and hip circumference were measured. Body mass index and waist/hip ratio were calculated. In children and adolescents with type1 diabetes mellitus insulin resistance of various degree was observed. The glucose disposal rate (M index) was 3.2 - 11.8 mg/kg/min., mean 7.08 +/- 2.5 mg/kg/min. The insulin resistance depended on patients' age (r= - 0.3, p<0.05,) and the stage of puberty. There was no difference in insulin secretion in insulin-resistant and insulin-sensitive subjects. The insulin resistance was related to BMI (r=-0.33; p=0.04), and with skinfold thickness (r=-0.59; p=0.001). In insulin-sensitive children the insulin dose was lower (0.45: 0.67; p<0.02). No influence of insulin resistance on metabolic control was observed. Insulin resistance is observed in newly diagnosed type 1 diabetic children and adolescents. No relationship between insulin secretion and impaired insulin action was found. Insulin resistance was greater during III Tanner stage of puberty and in obese children.