***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The proinflammatory cytokine interleukin-6 ( IL-6 ) may modulate the onset and progression of complications of diabetes . As this cytokine increases after exercise , and many other exercise responses are altered by prior glycemic fluctuations , we hypothesized that prior hyperglycemia might exacerbate the IL-6 response to exercise . Twenty children with type 1 diabetes ( 12 boys/8 girls , age 12 - 15 yr ) performed 29 exercise studies ( 30-min intermittent cycling at approximately 80 % peak O2 uptake ) . Children were divided into four groups based on highest morning glycemic reading [ blood glucose ( BG ) < 150 , BG 151 - 200 , BG 201 - 300 , or BG > 300 mg/dl ] . All exercise studies were performed in the late morning , after hyperglycemia had been corrected and steady-state conditions ( plasma glucose < 120 mg/dl , basal insulin infusion ) had been maintained for > or = 90 min . Blood sample s for IL-6 , growth factors , and counterregulatory hormones were drawn at pre- , end- , and 30 min postexercise time points . At all time points , circulating IL-6 was lowest in BG < 150 and progressively higher in the other three groups . The  exercise-induced increment also followed a similar dose-response pattern ( BG < 150 , 0.6 + /- 0.2 ng/ml ; BG 151 - 200 , 1.2 + /- 0.8 ng/ml ; BG 201 - 300 , 2.1 + /- 1.1 ng/ml ; BG > 300 , 3.2 + /- 1.4 ng/ml ) . Other measured variables ( growth hormone , IGF-I , glucagon , epinephrine , cortisol ) were not influenced by prior hyperglycemia . Recent prior hyperglycemia markedly influenced baseline and exercise-induced  levels of IL-6 in a group of peripubertal children with type 1 diabetes . While exercise is widely encouraged and indeed often considered part of diabetic management , our data underscore the necessity to completely underst and all adaptive mechanisms associated with physical activity , particularly in the context of the developing diabetic child BACKGROUND Type 1 diabetes mellitus ( T1DM ) is characterized by an immunological reaction that is dominated by type-1 T helper ( Th1 ) cells , whereas immunoglobulin E (IgE)-mediated allergies are associated with Th2 cell . According to the Th1/Th2-hypothesis , the immune system is said to either develop into the direction of Th1 or Th2 cells . This would mean that a child developing T1DM is unlikely to develop an IgE-mediated allergy and vice versa . OBJECTIVE The aim of the study was to investigate the association between the prevalence of T1DM and IgE-mediated allergies . METHODS We design ed a prospect i ve case control study with 94 children and adolescents with T1DM and 188 age- and sex-matched control children . The basis of our investigations was a question naire concerning the family and children 's history as to the presence of IgE-mediated allergies . Moreover , the following blood investigations were done : total serum IgE , specific IgE antibodies to major inhalant allergens , and a multiplex cytokine analysis measuring levels of specific cytokines representing either Th1- or Th2- cytokines . RESULTS Children with T1DM reported the presence of IgE-mediated allergies significantly more often than children of the control group . Children with T1DM had significantly higher tumor necrosis factor alpha ( TNFα ) levels than healthy controls . Levels of interleukin-2 ( IL-2 ) and IL-6 were higher in the groups of children with the presence of a personal history of allergies , regardless of the presence of T1DM . CONCLUSIONS Our results suggest that T1DM is associated with a higher risk of a self-reported presence of IgE-mediated allergies and that the Th1/Th2-hypothesis may be an oversimplification AIMS To investigate how reduction of hyperglycaemia affects acute phase serum proteins in poorly controlled type 1 diabetic patients . METHODS 24 patients ( age 31.7 + /- 2.0 years , HbA1c 9.3 + /- 0.2 % , BMI 24.2 + /- 0.7 kg/m2 , diabetes duration 15.3 + /- 1.7 years ) participated in the study . The treatment was optimised for 16 weeks . Blood sample s  were taken at baseline and at the end of the study . 16 healthy age- and BMI -matched subjects were chosen for a control group . RESULTS At baseline , the patients had higher C-reactive protein ( CRP ) ( 1.09 , median [ range 0.24 - 18.82 ] mg/l vs. 0.66 [ 0.18 - 2.46 ] mg/l , p < 0.02 ) , mean adiponectin ( 16.06 + /- 1.31 vs. 8.85 + /- 0.93 mg/l , p < 0.001 ) , ceruloplasmin ( 306 + /- 16.1 vs. 205.4 + /- 5.5 mg/l , p < 0.001 ) , fibrinogen ( 3.41 + /- 0.26 vs. 2.38 + /- 0.07 g/l , p < 0.001 ) , soluble intercellular adhesion molecule-1 ( sICAM-1 ) ( 255.4 + /- 10.3 vs. 194 + /- 10.6 microg/l , p < 0.001 ) , soluble vascular adhesion molecule-1 ( sVCAM-1 ) ( 533.4 + /- 21.8 vs. 422.9 + /- 20.7 microg/l , p < 0.01 ) and interleukin-6 ( 2.89 + /- 0.49 vs. 1.35 + /- 0.30 ng/l , p < 0.01 ) concentrations than the controls . During intensified treatment , HbA1c decreased ( to 8.5 + /- 0.2 % , p < 0.001 ) . This result ed in reduced sE-selectin ( from 44.6 + /- 2.6 to 38.8 + /- 2.6 microg/l , p < 0.01 ) , alpha-1-acid-glycoprotein ( A1GP ) ( from 622.9 + /- 47.9 to 525.7 + /- 27.9 mg/l , p < 0.01 ) , sICAM-1 ( from 255.4 + /- 10.3 to 240.8 + /- 9.1 microg/l , p < 0.05 ) and IL-6 ( from 2.9 + /- 0.5 to 2.1 + /- 0.4 ng/l , p < 0.01 ) . Serum amyloid A ( SAA ) and CRP did not change 12.00 ( 0.7 - 222.0 ) vs. 12.00 ( 1.6 - 277.0 ) mg/l for SAA and 1.09 ( 0.24 - 18.82 ) vs. 1.09 ( 0.18 - 23.08 ) mg/l for CRP , baseline vs. treatment , respectively . CONCLUSIONS Poorly controlled type 1 diabetic patients have increased values of adiponectin , CRP , ceruloplasmin , fibrinogen , sICAM-1 , sVCAM-1 and IL-6 . Reduction of hyperglycaemia results in decreased sE-selectin , A1GP , sICAM-1 and IL6 , while other inflammatory factors including CRP , SAA and adiponectin are not affected Abstract Vitiligo is a pigmentation disorder of unknown aetiology , but it has been reported in association with other autoimmune diseases including type 1 diabetes mellitus ( T1D ) . Vitiligo and T1D share a common theory of autoimmunity , but still an inflammatory link between them remains to be investigated . This study investigates the status and contribution of the inflammatory markers tumour necrosis factor-α ( TNFa ) , interleukin (IL)-6 and IL-1 in patients with vitiligo , T1D and vitiligo-associated T1D ( Vt-T1D ) . The data showed that sera from Vt-T1D patients ( n=21 ) had higher levels of TNFa , IL-6 and IL-1ß compared with vitiligo patients ( n=39 ) , T1D patients ( n=37 ) or controls ( n=42 ) .  Interestingly , serum levels of IL-6 were found to be significantly higher in Vt-T1D patients compared with the levels of TNFa and IL-1ß . These data also showed that IL-6 was high in Vt patients as compared to the levels of TNFa and IL-1ß , whereas in T1D patients , IL-6 and TNFa were almost the same but were higher than IL-1ß . In conclusion , this is the first study to show an inflammatory link between vitiligo and T1D . The data conclude that IL-6 plays an important role in the pathogenesis of Vt-T1D patients and is likely to gain favour as a therapeutic target in these patients 1 . The present study was undertaken to examine the effects of exercise and carbohydrate ( CHO ) ingestion on interleukin-6 ( IL-6 ) gene expression in skeletal muscle and plasma IL-6 concentration . 2 . Seven moderately trained men completed 60 min of exercise  at a workload corresponding to each individual 's lactate threshold on four r and omised occasions . Two trials were conducted on a bicycle ergometer ( Cyc ) and two on a running treadmill ( Run ) either with ( CHO ) or without ( Con ) the ingestion of a CHO beverage throughout the exercise . Muscle biopsies were obtained from the vastus lateralis before and immediately after exercise and IL-6 gene expression in these sample s was determined using real-time PCR . In addition , venous blood sample s were collected at rest , and after 30 min during and at the cessation of exercise . These sample s were analysed for plasma IL-6 . 3 . Irrespective of exercise mode or CHO ingestion , exercise result ed in a 21 + /- 4-fold increase ( P < 0.01 ; main exercise effect ) in IL-6 mRNA expression . In contrast , while the mode of exercise did not affect the exercise-induced increase in plasma IL-6 , CHO ingestion blunted ( P < 0.01 ) this response . 4 . These data demonstrate that CHO ingestion attenuates the plasma IL-6 concentration during both cycling and running exercise . However , because IL-6 mRNA expression was unaffected by CHO ingestion , it is likely that the ingestion of CHO during exercise attenuates IL-6 production by tissues other than skeletal muscle OBJECTIVE To determine the effect of the initial metabolic imbalance and its restoration after insulin therapy on adiponectin and acylated ghrelin levels in children with type 1 diabetes mellitus ( T1DM ) . STUDY DESIGN Twenty prepubertal children with newly diagnosed T1DM were prospect ively studied at diagnosis and after 1 and 4 months of therapy .  Body mass index ( BMI ) and serum levels of adiponectin , resistin , total and acylated ghrelin , leptin , tumor necrosis factor alpha ( TNF-alpha ) , and interleukin-6 ( IL-6 ) were determined . The control group comprised 40 healthy prepubertal children . RESULTS BMI was decreased at diagnosis , normalized at 1 month , and remained so thereafter . Adiponectin levels at diagnosis were similar to controls , increasing significantly after 1 month and normalizing at 4 months . Acylated ghrelin levels were lower at diagnosis , with a significant increase at 1 month and normalizing at 4 months . Resistin levels were normal at all time points . Leptin levels were decreased , while TNF-alpha and IL-6 were increased at diagnosis and normalized at 1 month . CONCLUSIONS These findings suggest that BMI is not the main predictor of acylated ghrelin or adiponectin levels in newly diagnosed T1DM subjects and that these peptides may play an important role in the metabolic adaptation in this disease 
    Output:
    
Conclusions : Patients with T1DM were found to be linked to elevated level of serum IL‐6 , which the age , ethnic and disease duration s in T1DM patients had no effect on the serum IL‐6 levels for promoting diabetes mellitus