Acute Respiratory Viral Infections Aggravate Arterial Endothelial Dysfunction in Children With Type 1 Diabetes
- Elhadi Aburawi, MD1,
- Petru Liuba, MD, PHD1,
- Erkki Pesonen, MD, PHD1,
- Seppo Ylä-Herttuala, MD, PHD2 and
- Sture Sjöblad, MD, PHD3
- 1Division of Pediatric Cardiology, Lund University Hospital, Lund, Sweden
- 2A.I. Virtanen Institute, University of Kuopio, Kuopio, Finland
- 3Division of Pediatric Metabolism, Endocrinology, and Diabetology, Lund University Hospital, Lund, Sweden
- Address correspondence and reprint requests to Petru Liuba, PhD, MD, Pediatric Cardiology, Lund University Hospital, 221 85 Lund, Sweden. E-mail: petru.liuba{at}pedi.lu.se
- CRP, C-reactive protein
- FMD, flow-mediated dilatation
- GTN, glyceryl-trinitrate
- vWF, von Willebrand antigen
Despite improvements in therapy for children with type 1 diabetes, the prevalence of cardiovascular morbidity in adulthood due to accelerated atherosclerosis remains significant (1). Similar to other cardiovascular risk factors, the diabetic state facilitates arterial endothelial injury, a primary event in the pathogenesis of atherosclerosis (2). Although several pediatric studies have reported an association of diabetes with arterial endothelial dysfunction (3,4), pathogenic animal studies have suggested that even though this disease predisposes to endothelial dysfunction and atherosclerosis, it might not be sufficient to cause them (5).
Notably, type 1 diabetes increases the propensity for both chronic and acute infections in part by weakening the immune mechanisms (6). The risk is particularly increased for respiratory tract infections, but other infections have also been associated with diabetes (7). Furthermore, diabetic patients are at greater risk for infection-related mortality (8), and the excess risk appears to be linked to cardiovascular diseases (9). In the present study, we investigated whether viral respiratory tract infections in children with type 1 diabetes might impose an additional burden on the arterial endothelial function.
RESEARCH DESIGN AND METHODS
A total of 26 children (aged 6–18 years, mean [±SD] age 14 ± 3 years) with type 1 diabetes (duration 6 ± 3 years) were recruited. Of these, 11 children had a clinically manifested upper respiratory tract infection (body temperature >38°C and flu-like symptoms) 6–8 weeks before the …
