Serum Neuron-specific Enolase and S100 Calcium-binding Protein B in Pediatric Diabetic Ketoacidosis
Hatem Hamed Elshorbagy1, Naglaa Fathy Barseem2, Akram Elshafey Elsadek3, Ashraf Hamed Al-shokary3, Yehia Hamed Abdel Maksoud3, Sameh Elsayed Abdulsamea3, Iman M. Talaat4, Hany Abdelaziz Suliman3, Naglaa M. Kamal5, Waleed E. Abdelghani3, Sanaa Mohammed Azab6, Dalia Mohamed Nour El Din71Menoufia University Faculty of Medicine, Departments of Pediatrics and Pediatric Neurology, Shebeen Elkom, Egypt; Alhada and Taif Armed forces Hospitals, Departments of Pediatrics and Pediatric Neurology, Taif, Saudi Arabia2Menofia University Faculty of Medicine, Department of Pediatrics, Shebeen Elkom, Egypt
3Benha University Faculty of Medicine, Department of Pediatrics, Al Obour, Egypt
4Ain Shams University Faculty of Medicine, Department of Pediatrics, Cairo, Egypt
5Cairo University Faculty of Medicine, Departments of Pediatrics and Pediatric Hepatology, Cairo, Egypt; Alhada Armed forces Hospital, Clinics of Pediatric Hepatology and Gastroenterology, Taif, Saudi Arabia
6Al-Azhar University Faculty of Medicine, Department of Pediatrics, El-Khalifa, Egypt
7Benha University Faculty of Medicine, Department of Clinical Pathology, Benha, Egypt
Objective: Neuron-specific enolase (NSE) and S100 calcium-binding protein B (S100B) are markers of different neurological disorders. The aim was to investigate the relationship between NSE and S100B serum concentrations and the severity of diabetic ketoacidosis (DKA) in diabetic children.
Methods: Eighty children with DKA, 40 with type 1 diabetes mellitus (T1DM) without DKA and 40 healthy controls were enrolled. Severity of DKA was assessed according to blood pH and bicarbonate concentration. Serum NSE and S100B were measured in all participants. In the DKA group serum NSE and S100B were measured at three time points, at admission and at 12 hours and 24 hours after starting treatment.
Results: Children with DKA showed significantly higher serum levels of NSE at all time points compared to children with T1DM without DKA and controls (p<0.01), while serum S100B concentrations did not differ between the three cohorts. Children with T1DM but without DKA also had significantly higher serum levels of NSE (p<0.01) compared to healthy controls. Patients with low Glasgow Coma Scale score (GCSS) and those with moderate and severe DKA had significantly higher levels of NSE at all time points (p<0.01 for each) compared to patients with normal GCSS and those with mild DKA. No significant differences were found in serum S100B levels according to the severity of DKA and GCS (p>0.05). Younger age, lower GCSS, higher glucose and HbA1c, lower pH and lower serum bicarbonate were the risk factors associated with elevated NSE.
Conclusion: Serum NSE is elevated in all patients with type 1 DM and, in patients with DKA, correlates with severity of DKA. However, serum S100B concentration did not differ between T1DM with or without DKA and healthy controls.
Manuscript Language: English
