Our findings suggest that endothelial dysfunction may be already present in children with 5 years or more elapsed since diagnosis, even in the absence of atherosclerotic structural changes. The decreased vasodilation response correlated with hyperglycemia.

Type 1 Diabetes mellitus (DM1) displays an increasing global prevalence and its resultant cardiac, cerebral and peripheral vascular complications represent important risk factor for high morbidity and mortality in adult life. The development of DM1 vascular complications is preceded by endothelial dysfunction that result in systemic vasoconstriction and contribute to the progress to a pro-inflammatory and pro-thrombotic state. Objective: The purpose of this study was to verify the presence of endothelial dysfunction and initial structural changes of atherosclerosis in diabetic children. Methods: Thirty-one diabetic children aged 6-12 years, divided in two subgroups according to disease length composed the study group: subgroup 1, with less than five years and subgroup 2, with more than five years of disease span. Fifty-eight age-matched healthy children composed the control group. Ultrasonographic techniques were used to measure the flow-mediated dilatation of the brachial artery (FMD), and the intima-media thickness of carotid arteries (IMT). The ultrasonographic findings were correlated to plasmatic levels of inflammatory biomarkers (IL-6, hs-CRP), endothelial dysfunction (sE-selectin, sVCAM-1, sICAM-1) and vascular injury biomarkers (MMP-9). Results: Diabetic children with increased disease length disclosed flow-mediated dilatation maximum percentage mean values significantly decreased when compared with the values found in the control group. Levels of sVCAM-1 were significantly higher in both diabetic subgroups while the levels of hs-CRP and sE-selectin were significantly higher only in the subgroup with more than five years of disease length when compared to controls. Study groups and controls did not disclosed significant differences in relation to IMT, IL-6, sICAM-1 and MMP-9 levels. Vasodilator response was negatively correlated to disease length, plasmatic levels of HbA1c and fasting glucose. Conclusion: Our findings suggest that endothelial dysfunction and a low level of systemic inflammatory state may be already present in diabetic children with five more than years of disease length, in spite of absence of atherosclerotic structural changes.