HbA1c but not diabetes duration predicts increased arterial stiffness in adolescents with poorly controlled type 1 diabetes
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
27075550
DOI
10.1111/pedi.12385
Knihovny.cz E-resources
- Keywords
- adolescents, arterial stiffness, blood pressure, pulse wave velocity, type 1 diabetes,
- MeSH
- Pulse Wave Analysis MeSH
- Biomarkers blood MeSH
- Diabetes Mellitus, Type 1 blood complications physiopathology therapy MeSH
- Diabetic Cardiomyopathies epidemiology prevention & control MeSH
- Diabetic Angiopathies epidemiology prevention & control MeSH
- Glycated Hemoglobin analysis MeSH
- Hyperglycemia prevention & control MeSH
- Cardiovascular Diseases complications epidemiology prevention & control MeSH
- Cohort Studies MeSH
- Combined Modality Therapy MeSH
- Referral and Consultation MeSH
- Humans MeSH
- Adolescent MeSH
- Hospitals, University MeSH
- Prevalence MeSH
- Disease Progression MeSH
- Cross-Sectional Studies MeSH
- Risk Factors MeSH
- Vascular Stiffness * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic epidemiology MeSH
- Names of Substances
- Biomarkers MeSH
- Glycated Hemoglobin A MeSH
- hemoglobin A1c protein, human MeSH Browser
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.
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