Sarveshinee Pillay1, Jemma Anderson2, Jennifer Couper2, Oana Maftei3, Roger Gent4, Alexia Sophie Peña2. 1. Robinson Research Institute and Discipline of Paediatrics, The University of Adelaide, Adelaide, South Australia, Australia; Endocrinology and Diabetes Centre, Women's and Children's Hospital, North Adelaide, South Australia, Australia. Electronic address: sarveshinee.pillay@gmail.com. 2. Robinson Research Institute and Discipline of Paediatrics, The University of Adelaide, Adelaide, South Australia, Australia; Endocrinology and Diabetes Centre, Women's and Children's Hospital, North Adelaide, South Australia, Australia. 3. Endocrinology and Diabetes Centre, Women's and Children's Hospital, North Adelaide, South Australia, Australia. 4. Medical Imaging, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Abstract
OBJECTIVES: Children with type 1 diabetes have accelerated atherosclerosis with early endothelial dysfunction as measured by reduced flow-mediated dilation (FMD) at 60 seconds postischemic stress (early FMD). Delayed dilation may also occur in the presence of cardiovascular risk factors and may be a more sensitive marker. No data exist that evaluate FMD beyond 60 seconds (delayed FMD) in children with type 1 diabetes. We aimed to compare early and delayed FMD in children with type 1 diabetes and in healthy children. METHODS: We studied 66 children 13.5±2.8 years of age; 29 were males. Of the 66 children, 38 had type 1 diabetes, and 28 were healthy age- and gender-matched controls. Evaluation of brachial artery FMD was performed at 60 seconds (FMD60s) and 120 seconds (FMD120s) postischemic stress. Early FMD was defined as peak FMD60s and delayed FMD as peak FMD120s. RESULTS: Children with type 1 diabetes had diabetes durations of 5.4±4.6 years and median glycated hemoglobin levels of 8.8 (6.6 to 14)% (73 [49 to 130] mmol/mol). Of the children, 8 with type 1 diabetes and 1 healthy child had delayed FMD; a relationship was seen between the prevalence of early FMD and delayed FMD in children with type 1 diabetes and healthy children, respectively (p=0.019). Children with type 1 diabetes and delayed FMD had lower FMD60s than children without delayed FMD (2.50±3.61 vs. 6.14±3.83 percentage units; p=0.02). Children with type 1 diabetes had lower FMD60s than healthy children (5.38±4.0 percentage units; p=0.03) but not FMD120s (7.56±3.5 percentage units; p=0.47). CONCLUSIONS: Delayed FMD patterns occur in children with type 1 diabetes and detect children who have more severe vascular abnormalities. The standard FMD60s remains the better marker to identify children at increased risk for cardiovascular disease.
OBJECTIVES:Children with type 1 diabetes have accelerated atherosclerosis with early endothelial dysfunction as measured by reduced flow-mediated dilation (FMD) at 60 seconds postischemic stress (early FMD). Delayed dilation may also occur in the presence of cardiovascular risk factors and may be a more sensitive marker. No data exist that evaluate FMD beyond 60 seconds (delayed FMD) in children with type 1 diabetes. We aimed to compare early and delayed FMD in children with type 1 diabetes and in healthy children. METHODS: We studied 66 children 13.5±2.8 years of age; 29 were males. Of the 66 children, 38 had type 1 diabetes, and 28 were healthy age- and gender-matched controls. Evaluation of brachial artery FMD was performed at 60 seconds (FMD60s) and 120 seconds (FMD120s) postischemic stress. Early FMD was defined as peak FMD60s and delayed FMD as peak FMD120s. RESULTS:Children with type 1 diabetes had diabetes durations of 5.4±4.6 years and median glycated hemoglobin levels of 8.8 (6.6 to 14)% (73 [49 to 130] mmol/mol). Of the children, 8 with type 1 diabetes and 1 healthy child had delayed FMD; a relationship was seen between the prevalence of early FMD and delayed FMD in children with type 1 diabetes and healthy children, respectively (p=0.019). Children with type 1 diabetes and delayed FMD had lower FMD60s than children without delayed FMD (2.50±3.61 vs. 6.14±3.83 percentage units; p=0.02). Children with type 1 diabetes had lower FMD60s than healthy children (5.38±4.0 percentage units; p=0.03) but not FMD120s (7.56±3.5 percentage units; p=0.47). CONCLUSIONS: Delayed FMD patterns occur in children with type 1 diabetes and detect children who have more severe vascular abnormalities. The standard FMD60s remains the better marker to identify children at increased risk for cardiovascular disease.
Authors: Ida Pastore; Andrea Mario Bolla; Laura Montefusco; Maria Elena Lunati; Antonio Rossi; Emma Assi; Gian Vincenzo Zuccotti; Paolo Fiorina Journal: Int J Mol Sci Date: 2020-07-12 Impact factor: 5.923
Authors: Michał Podgórski; Katarzyna Szatko; Małgorzata Stańczyk; Monika Pawlak-Bratkowska; Michał Fila; Ewa Bieniek; Marcin Tkaczyk; Piotr Grzelak; Maciej Łukaszewski Journal: Med Sci Monit Date: 2019-09-28