Impaired Endothelial Function in Preadolescent Children With Type 1 Diabetes
- Ghufran S. Babar, MD, MSC1,
- Hanaa Zidan, MD2,
- Michael E. Widlansky, MD, MPH3,4,
- Emon Das, MD4,
- Raymond G. Hoffmann, PHD5,6,
- Marwan Daoud, PHD7 and
- Ramin Alemzadeh, MD5,6
- 1Department of Pediatric Endocrinology, Children’s Mercy Hospital, Kansas City, Missouri
- 2Department of Pediatrics, Section of Pediatric Endocrinology, Children’s Hospital of Michigan, Detroit, Michigan
- 3Departments of Medicine and Pharmacology, Medical College of Wisconsin, Milwaukee, Wisconsin
- 4Cardiovascular Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin
- 5Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
- 6Children’s Research Institute, Children’s Hospital of Wisconsin, Milwaukee, Wisconsin
- 7Department of Pediatrics, Wayne State School of Medicine, Detroit, Michigan
- Corresponding author: Ramin Alemzadeh, .
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.
- © 2011 by the American Diabetes Association.
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