Arterial wall thickening and stiffening in children and adolescents with type 1 diabetes.
OBJECTIVE
We evaluated structural and functional characteristics of the common carotid artery (CCA), a marker of early carotid atherosclerosis, and investigated their relation to metabolic and anthropometric parameters in children and adolescents with type 1 diabetes.


METHODS
Non-invasive ultrasonographic measurements were made in 45 type 1 diabetic patients and 33 controls. Age, sex, and body mass index were matched between patients and controls. We investigated intima-media thickness (IMT), compliance, distensibility, diastolic wall stress (DWS) and incremental elastic modulus (IEM) of the CCA. Metabolic and anthropometric parameters such as serum lipids, plasma glycated haemoglobin, body mass index, waist-hip ratio and blood pressure were assessed.


RESULTS
The diabetic patients had significantly higher CCA-IMT than the controls (0.48+/-0.06mm versus 0.33+/-0.07mm; p<0.001). The diabetic children had significantly higher values than the controls for DWS (1.18+/-0.29mmHgx10(2) versus 0.81+/-0.25mmHgx10(2); p<0.001) and for IEM (1.26+/-0.57mmHgx10(3) versus 0.77+/-0.28mmHgx10(3); p<0.001). The difference was not significant between patients and controls for arterial compliance and for distensibility (p>0.05). In a multivariate regression model for all subjects, diabetic state was the best predictor of IMT (p<0.001), DWS (p<0.001) and IEM (p=0.001).


CONCLUSIONS
Our results suggested that children and adolescent patients with type 1 diabetes are associated with early impairment of CCA structure and function and that diabetic state may be the main risk factor for CCA wall stiffening and thickening, which are of considerable concern as possible early events in the genesis of atheroma.
Atabek
Mehmet Emre
ME
Department of Pediatric Endocrinology and Diabetes, School of Medicine, Selcuk University, Konya, Turkey. meatabek@hotmail.com
Kurtoglu
Selim
S
Pirgon
Ozgur
O
Baykara
Murat
M
D000293:Adolescent; D015992:Body Mass Index; D049628:Body Size; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000503:physiopathology*; D003971:Diastole; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016037:Single-Blind Method; D013314:Stress, Mechanical; D014463:Ultrasonography
D007004:Hypoglycemic Agents; D007328:Insulin