Impaired Endothelial Function in Preadolescent Children With Type 1 Diabetes

  1. Ramin Alemzadeh, MD5,6
  1. 1Department of Pediatric Endocrinology, Children’s Mercy Hospital, Kansas City, Missouri
  2. 2Department of Pediatrics, Section of Pediatric Endocrinology, Children’s Hospital of Michigan, Detroit, Michigan
  3. 3Departments of Medicine and Pharmacology, Medical College of Wisconsin, Milwaukee, Wisconsin
  4. 4Cardiovascular Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin
  5. 5Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
  6. 6Children’s Research Institute, Children’s Hospital of Wisconsin, Milwaukee, Wisconsin
  7. 7Department of Pediatrics, Wayne State School of Medicine, Detroit, Michigan
  1. Corresponding author: Ramin Alemzadeh, ralemzad{at}


OBJECTIVE We evaluated the prevalence of endothelial dysfunction as measured by flow-mediated dilatation (FMD) of the brachial artery and carotid intima-media thickness (c-IMT) in relationship to vascular inflammatory biomarkers in preadolescent children with type 1 diabetes.

RESEARCH DESIGN AND METHODS We studied 21 type 1 diabetic children (aged 8.3 ± 0.3 years with diabetes duration of 4.3 ± 0.4 years) and 15 group-matched healthy siblings (aged 7.6 ± 0.3 years). Fasting plasma glucose (FPG), lipid profile, HbA1c, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, homocysteine, and erythrocyte (red blood cell [RBC]) folate were evaluated in all subjects. Each subject underwent c-IMT and brachial artery FMD percentage (FMD%) measurements using high-resolution vascular ultrasound.

RESULTS Type 1 diabetic children had higher FPG (173.4 ± 7.9 mg/dL vs. 81.40 ± 1.7 mg/dL; P < 0.0001), HbA1c (8.0 ± 0.2% vs. 5.0 ± 0.1%; P < 0.0001), and hs-CRP (1.8 ± 0.3 vs. 0.70 ± 0.2; P = 0.017) than control children without significant differences in BMI, homocysteine, and fibrinogen levels; RBC folate content; and c-IMT between the groups. Children with type 1 diabetes had lower FMD% than control children (7.1 ± 0.8% vs. 9.8 ± 1.1%; P = 0.04), whereas c-IMT did not differ between groups.

CONCLUSIONS Preadolescent children with type 1 diabetes and mean diabetes duration of 4 years displayed evidence of low-intensity vascular inflammation and attenuated FMD measurements. These data suggest that endothelial dysfunction and systemic inflammation, known harbingers of future cardiovascular risk, are present even in preadolescent children.

  • Received November 12, 2010.
  • Accepted December 23, 2010.

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  1. Diabetes Care
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