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Longitudinal evaluation of endothelial function in children and adolescents with type 1 diabetes mellitus: A long‐term follow‐up study
Author(s) -
Bruzzi Patrizia,
Predieri Barbara,
Patianna Viviana Dora,
Salvini Annamaria,
Rossi Rosario,
Modena Maria Grazia,
Iughetti Lorenzo
Publication year - 2014
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12220
Subject(s) - medicine , brachial artery , endothelial dysfunction , type 1 diabetes , diabetes mellitus , disease , cardiology , population , longitudinal study , pediatrics , blood pressure , endocrinology , pathology , environmental health
Background Type 1 diabetes ( T1DM ) predisposes to cardiovascular disease, increasing the risk to develop atherosclerosis. In the pediatric population, the cardiovascular risk may be evaluated examining endothelial function by a non‐invasive ultrasound technique, namely flow‐mediated dilation ( FMD ) of the brachial artery. The aims of this study were the longitudinal evaluation of the potential change in the endothelium‐dependent vasomotor function in children and adolescents with T1DM and the identification of clinical and laboratory data correlated to modifications. Methods We studied 39 T1DM patients (20 girls and 19 boys; aged 11.2 ± 3.72 years). FMD and blood samples were obtained from all patients at baseline (time 0) and after a follow up of at least 1 year (time 1). FMD was also evaluated in 45 healthy controls (22 boys, 23 girls) aged 10.2 ± 3.05 years. Results At time 0, 43.6% of T1DM patients presented an impaired FMD . FMD at time 1 revealed a dramatic impairment of endothelial function: altered FMD values were shown in 61.5% of patients and it got worse in 74.3% of them. Longitudinally, boys had a greater impairment of FMD than girls. At baseline, multivariate analysis identified only sex as significant predictor of FMD (β = 0.470, P = 0.029). Conclusions Because endothelial dysfunction appears earlier in diabetic children, they are at higher risk to develop atherosclerosis. Our results suggest the usefulness of FMD as a tool to stratify pediatric T1DM patients according to their cardiovascular risk and to follow them up longitudinally.