Hs-CRP is associated with weight, BMI, and female sex but not with endothelial function in children with type 1 diabetes.
BACKGROUND
Atherosclerosis is an inflammatory process, and high-sensitivity C-reactive protein (Hs-CRP), a marker of inflammation, predicts cardiovascular events in adults. Vascular endothelial and smooth muscle dysfunction, measurable precursors of atherosclerosis, begin in childhood. Therefore, we sought to determine if Hs-CRP is associated with vascular endothelial and smooth muscle dysfunction in children with type 1 diabetes mellitus (T1DM) and healthy control subjects.


METHODS
Hs-CRP and endothelial function assessed by flow-mediated dilatation (FMD) and smooth muscle function assessed by glyceryl-trinitrate (GTN)-induced dilatation were measured in 121 subjects with T1DM aged 14.1 (2.9) yr, of whom 31 were also studied at 4 and 8 wk, and in 33 healthy controls aged 14.2 (3.6) yr.


RESULTS
Hs-CRP did not differ between subjects with T1DM and healthy, age-matched controls. In both controls and subjects with T1DM, Hs-CRP did not relate to FMD or GTN at baseline or at intervals over 8 wk in T1DM. Hs-CRP did not change over time. In T1DM, but not healthy controls, Hs-CRP related to body mass index (BMI) z-score (r = 0.47, p < 0.001), weight z-score (r = 0.41, p < 0.001), and female sex (p = 0.008).


CONCLUSIONS
Hs-CRP is not associated with early vascular dysfunction in children with T1DM. However, in children and adolescents with T1DM, Hs-CRP was associated with female sex and children with higher BMI, suggesting that these groups may be at greater cardiovascular risk. Maintenance of a healthy BMI may be important in the prevention of vascular disease of T1DM.
MacKenzie
Karen E
KE
Department of Diabetes and Endocrinology, Women's and Children's Hospital, Adelaide, South Australia, Australia. karen.mackenzie@cdhb.govt.nz
Wiltshire
Esko J
EJ
Peña
Alexia S
AS
Gent
Roger
R
Hirte
Craig
C
Piotto
Lino
L
Couper
Jennifer J
JJ
D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D012016:Reference Values; D012727:Sex Characteristics; D014463:Ultrasonography
D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin