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HbA1c but not diabetes duration predicts increased arterial stiffness in adolescents with poorly controlled type 1 diabetes
Author(s) -
Obermannova Barbora,
Petruzelkova Lenka,
Sulakova Terezie,
Sumnik Zdenek
Publication year - 2017
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12385
Subject(s) - medicine , arterial stiffness , diabetes mellitus , type 2 diabetes , type 1 diabetes , duration (music) , cardiology , endocrinology , blood pressure , art , literature
Background The prevalence of macrovascular complications is probably underestimated in children with type 1 diabetes ( T1D ). Arterial stiffness ( AS ) is a subclinical marker of cardiovascular ( CV ) risk. The most validated, non‐invasive method for AS measurement is pulse wave velocity ( PWV ). Only a few PWV studies have been performed in children with T1D . Objective To explore the risk factors associated with AS in adolescents with suboptimally controlled T1D . Patients and methods Seventy‐seven adolescents with T1D were included (39 girls, 38 boys) in this study. The adolescents had a median age of 16 yr ( IQR 14–17), median duration of T1D was 9 yr ( IQR 6–16), and HbA1c 71 mmol/mol (median, IQR 62–81). PWV was measured as the carotid‐femoral pulse transmission time and converted into standard deviation scores ( SDS ) (adjusted for gender and age) using normative values for children. The risk factors assessed were HbA1c , T1D duration, treatment modality, serum lipids, and blood pressure ( BP ) measured via ambulatory blood pressure monitoring ( ABPM ). Results The PWV did not differ from the reference data (median PWV was 5.1 m/s, i.e., −0.01 SDS ). A significant positive association was observed between PWV‐SDS and HbA1c (p = 0.001), total cholesterol (p = 0.003), LDL ‐cholesterol (p = 0.003), but not T1D duration (p = 0.78) according to the univariate analyses. In the multivariate model, the only significant variable that remained positively associated with PWV‐SDS was HbA1c (p = 0.03). Conclusions Most adolescents with suboptimally controlled T1D have normal mean PWV compared to a healthy reference population. Chronic hyperglycemia, not T1D duration, is the main predictor of AS in adolescents.