الفهرس 
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Abstract
This study aimed to investigate whether these inflammatory proteins growth/differentiation factor 15 (GDF-15) and interleukin 29 are related to the prevalence of microvascular complications and markers of glycemic control in Type 1diabetes patients.
This study was comparative cross-sectional, included 80 participants; 40 children with T1DM (18 T1DM patients had microvascular complications and 22 T1DM patients were free of these complications; their ages ranged from 8 to 18 years); there was also another subgroup of T1DM according to the glycemic control (11 T1DM patients had controlled HbA1c < 7% and 29 patients had uncontrolled HbA1C > 7%). 40 children of the same age were selected as a control group. The diagnosis of TIDM was made based on the criteria of the International Society of Pediatric and Adolescent Diabetes (ISPAD) (2022).
Inclusion Criteria:
Type 1 diabetes Children and adolescent for more than 5 years.
Exclusion Criteria:
1. Acute inflammation.
2. Any clinical evidence of infection (CRP >10 mg/L)
3. Diabetic ketoacidosis or ketonuria.
4. Neoplasm.
5. Autoimmune disorders: Sjögren syndrome, rheumatoid arthritis, systemic sclerosis, and psoriasis.
6. Atopic dermatitis and asthma.
7. Pulmonary disease.
In the present study our markers GDF-15 and IL-29, the comparative statistical study showed the mean serum GDF15 level was significantly higher in T1DM than healthy controls (p = 0.041) due to in hyperglycemic conditions, increased reactive oxygen species (ROS) formation leads to cellular injury and cell death. Increased ROS cells can cause apoptosis, which increases GDF-15 to protect endothelial cells against cellular injury.
Also, the mean serum level of IL-29 was significantly higher in T1DM more than healthy controls. That may be due to the fact that IL-29 regulates the production of inflammatory cytokines and therefore may play a potential role in autoimmune.
Also, a statistically significant difference was found in the serum level of GDF15 in the patient subgroups which was higher in patients with microvascular complications more than patients free of complications (P = 0.001). In our study GDF-15 was highly statistically significant in diabetic nephropathy. In addition, there was no statistically significant association between the serum level of GDF-15 and diabetic retinopathy and diabetic neuropathy. This may be due to these complications are less common in children at this age and may occur later on, or it may be due to the small sample size of these complications in our studied patients. However, no statistically significant difference was found in the serum level of IL-29 between diabetic subgroups
In our study, GDF-15 was significantly higher in uncontrolled diabetes than in controlled diabetes (P = 0.001). However, there was no statistically significant difference found in the biomarker IL-29 between the controlled group HbA1c < 7% and the uncontrolled group HbA1c >7%.