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Ambulatory blood pressure and carotid intima media thickness in children with type 1 diabetes
Author(s) -
Glackin Sinead,
Islam Nazrul,
Henderson Amanda M.,
Dionne Janis M.,
Harris Kevin C.,
Panagiotopoulos Constadina,
Devlin Angela M.
Publication year - 2020
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.12960
Subject(s) - medicine , ambulatory blood pressure , type 2 diabetes , blood pressure , diabetes mellitus , cardiology , subclinical infection , odds ratio , type 1 diabetes , confidence interval , intima media thickness , macrovascular disease , ambulatory , pediatrics , endocrinology , carotid arteries
Background/Objective Blood pressure abnormalities may play an important role in macrovascular damage in type 1 diabetes. Little is known about blood pressure abnormalities and macrovascular damage in children with type 1 diabetes. Methods Children with type 1 diabetes (n = 57) for a short (3 months‐2 years; n = 24) or long duration (≥5 years; n = 33) and a group of control children without diabetes (n = 29) completed 24‐h ambulatory blood pressure monitoring (ABPM). Carotid intima media thickness (cIMT), a subclinical indicator of atherosclerosis, was assessed by carotid ultrasound. Results ABPM abnormalities were more prevalent (57% vs 24%, respectively), and daytime, nighttime and 24‐h systolic, diastolic, and mean arterial blood pressure indices were higher in children with type 1 diabetes compared to control children. The odds estimate of an ABPM abnormality was 6.68 (95% confidence interval: 1.95, 22.9; P = .003) in children with type 1 diabetes compared to controls after adjusting for age, sex, and BMI standardized for age and sex (zBMI). An interaction between ABPM and zBMI on cIMT was observed. In children with type 1 diabetes and ABPM abnormalities, every 1 SD increase in zBMI was associated with a 0.030 mm increase in cIMT (95% confidence interval: 0.002, 0.041; P = .031). This was not observed in control children with ABPM abnormalities or in children with normal ABPM, regardless of type 1 diabetes status. Conclusions Children with type 1 diabetes have a high prevalence of ABPM abnormalities independent of disease duration and this is related to early indicators of cardiovascular damage.