Adolescents and young adults with type 1 diabetes display a high prevalence of endothelial dysfunction

Scaramuzza, Andrea; Redaelli, Francesca; Giani, Elisa; Macedoni, Maddalena; Giudici, Valentina; Gazzarri, Alessandra; Bosetti, Alessandra; Angelis, Laura De; Zuccotti, Gian Vincenzo

doi:10.1111/apa.12877

Cited by 18 publications

(25 citation statements)

References 30 publications

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“…In pubertal children without diabetes but with familial hypercholesterolemia, statin therapy is known to be safe and effective at lowering LDL-C levels and attenuating progression of surrogate markers for future CVD (178). Different markers of future CVD are being explored to better predict when to intervene (179)(180)(181)(182).…”

Section: Dyslipidemiamentioning

confidence: 99%

Type 1 Diabetes in Children and Adolescents

Wherrett¹,

Ho²,

Huot³

et al. 2018

Canadian Journal of Diabetes

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Section: Dyslipidemiamentioning

confidence: 99%

Type 1 Diabetes in Children and Adolescents

Wherrett¹,

Ho²,

Huot³

et al. 2018

Canadian Journal of Diabetes

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“…These young children confront a long period of hyperglycemia in their prepubertal years with the danger of early occurrence of micro-and macrovascular complications [1]. In spite of the fact that complications from T1DM are rare among children, endothelial dysfunction which is an early pointer of vascular insufficiency may happen [2,3]. Around 80% of patients with diabetes die from thrombotic events; 75% of these passings are because of cardiovascular complications and the rest due to cerebrovascular and peripheral vascular diseases [4].…”

Section: Introductionmentioning

confidence: 99%

Urinary Markers of Oxidative Dna Damage in Type 1 Diabetic Children: Relation to Microvascular Complications

Wakeel¹,

Abou-El-Asrar²,

El-Kassas³

et al. 2017

Asian J Pharm Clin Res

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Objective: Type 1 diabetes mellitus (T1DM) is a widespread metabolic disease, which frequently carries with it a significant impact on human health. Oxidative damage and tissue inflammation have been claimed to be a typical pathogenic component for the progression of diabetic complications. We aim in this study to explore the relation of urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG) (as a marker of nucleic acid oxidation) to microvascular complications in T1DM.Methods: A case–control study, enrolling 45 T1DM children and an equivalent number of healthy subjects, was performed. Full clinical examination and anthropometric measurement were performed to all subjects. Urinary assessment for 8-oxodG and albumin was done in addition to blood sampling for lipid profile and glycated Hb (HbA1c) assay. Complete ocular examination for assessment of diabetic retinopathy (DR) was also done.Results: Levels of urinary 8-oxodG, serum cholesterol, triglycerides, and low-density lipoprotein in cases were significantly higher than non-diabetics; these levels were likewise higher in uncontrolled T1DM patients in comparison with well-controlled T1DM subjects. Urinary 8-oxodG and HbA1c were significantly higher in diabetic patients with albuminuria and DR compared to patients without complications. Significant positive correlation was found between 8-oxodG with HbA1c (r=0.8, p<0.01), diastolic blood pressure (DBP) (r=0.4, p=0.02), and cholesterol (r=0.4, p=0.05).Conclusion: Urinary 8-oxodG was found to be a reliable marker for assessing oxidative DNA damage in T1DM and can be used in the determination of microvascular complications related to diabetes.

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“…Previous studies done in children and adolescents with diabetes are mainly in T1DM patients (7,10,(14)(15)(16)(17). Prospective studies with the EndoPAT on T1DM adolescents revealed the presence of endothelial dysfunction in 76.7% (7), and a negative correlation between endothelial function and A1C (10). In our study, latest A1C (within 3 months prior to the use of the EndoPat) was an important predictor of endothelial function.…”

Section: Discussionmentioning

confidence: 98%

“…The EndoPAT (peripheral arterial tonometry) is a non-invasive device that measures endothelial function calculated as reactive hyperemic index (RHI). The greater the vasodilation, the higher the RHI (7). A Mayo clinic study (8) which compared the EndoPAT results to coronary injection of acetylcholine via cardiac catheterization, concluded that the normal RHI should be > 1.67.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Microvascular Function in Children and Adolescents with Diabetes and Obesity

Kochummen

Umpaichitra

Marwa

et al. 2019

Int J Endocrinol Metab

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Background: Endothelial dysfunction (ED) is a marker of vascular damage. Glycated hemoglobin (A1C) predicts vascular complications. The EndoPAT (peripheral arterial tonometry) device calculates the reactive hyperemic index (RHI), a measure of endothelial function. The greater the vasodilation, the higher the RHI. We hypothesized that children with poorly-controlled diabetes mellitus (DM) and non-diabetes mellitus (NDM) obese children have ED. Methods: A cross-sectional study using the EndoPAT device was performed on children with poorly-controlled DM and NDM children. ANOVA, t-test, Mann-Whitney U test, multiple linear regression and Spearman correlation were used. Results:Of 58 children that completed the study (aged 13.1 ± 3.42 years), 33 with type 1 diabetes (T1DM), 8 with type 2 diabetes (T2DM) and 17 were NDM obese children. Eighty-five percent were African-American, 60% were female and 79% entered puberty. The RHI of children with DM (1.42 ± 0.48) versus NDM obese group (1.40 ± 0.34) was not different (P = 0.86) regardless of the type of DM or body mass index. In the DM group, for every 1% increase in latest A1C, the RHI decreased by 0.097 (P = 0.01) after adjusting for age, gender, and type of DM. The RHI of DM patients with latest A1C of < 10% (1.70 ± 0.58) versus those with A1C ≥10% (1.21 ± 0.19) was statistically different (P = 0.02). In the total study population, males had significantly lower RHI (1.28 ± 0.36) when compared to females (1.51 ± 0.46), P = 0.04 but this difference disappeared when considering pubertal status and type of diabetes. Conclusions: Our data showed that patients with poorly-controlled DM as reflected by latest A1C of ≥ 10% had worse endothelial function as reflected by lower RHI score.

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Adolescents and young adults with type 1 diabetes display a high prevalence of endothelial dysfunction

Abstract: Adolescents with type 1 diabetes displayed evidence of endothelial dysfunction. Good metabolic control (glycated haemoglobin ≤7.5%, 58 mmol/mol) and regular physical activity of at least 4 h a week might be protective.

Cited by 18 publications

References 30 publications

Type 1 Diabetes in Children and Adolescents

Type 1 Diabetes in Children and Adolescents

Urinary Markers of Oxidative Dna Damage in Type 1 Diabetic Children: Relation to Microvascular Complications

Assessment of Microvascular Function in Children and Adolescents with Diabetes and Obesity

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