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Early Signs of Cardiovascular Disease in Youth With Obesity and Type 2 Diabetes

¹ Division of Pediatric Endocrinology Metabolism and Diabetes Mellitus, Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
² Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
³ Division of Biostatistics, Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania

Address correspondence and reprint requests to Silva Arslanian, MD, Division of Endocrinology, Children’s Hospital of Pittsburgh, 3705 Fifth Avenue at DeSoto Street, Pittsburgh, PA 15213. E-mail: silva.arslanian@chp.edu

Abbreviations: aPWV, aortic pulse wave velocity • CVD, cardiovascular disease • hs-CRP, high-sensitivity C-reactive protein • IMT, intima media thickness • HOMA-IS, homeostasis model assessment of insulin sensitivity

The first 20% of the full text of this article appears below.

	INTRODUCTION

 
Atherosclerotic cardiovascular disease (CVD) is the major cause of mortality and morbidity in adults with type 2 diabetes (1). The origin of atherosclerosis is early in childhood with progression toward clinically significant lesions in young adulthood (2,3).

Carotid artery intima media thickness (IMT) and aortic pulse wave velocity (aPWV), a measure of arterial stiffness, are noninvasive measures of subclinical atherosclerosis that have been used as surrogate measures of cardiovascular events in various adult studies (4–9). Data regarding IMT and arterial stiffness in children are limited despite the increasing tide of obesity and type 2 diabetes. Therefore, in this pilot study, we aimed 1) to evaluate IMT and aPWV in obese adolescents with type 2 diabetes and 2) to investigate the relationship between these vascular markers and the clinical/metabolic risk factors of CVD.

	RESEARCH DESIGN AND METHODS

 
We studied 20 adolescents with type 2 diabetes (undetectable islet-cell and GAD65 autoantibodies, duration 1.7 ± 0.4 years) and 22 normal-weight and 20 obese healthy control subjects. The groups were comparable for age, sex, ethnicity, and puberty assessed by Tanner criteria (10) (Table 1). Type 2 diabetic subjects were receiving either metformin or rosiglitazone (7), metformin with insulin (5), insulin alone (1), and metformin and acarbose (1) in addition to lifestyle modification. None of the . . . [Full Text of this Article]

Statistical analysis

	RESULTS

 

	CONCLUSIONS

 

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