Subclinical vascular alterations in young adults with type 1 diabetes detected by arterial tonometry.
BACKGROUND
Diabetes mellitus is characterized by a very high prevalence of atherosclerotic disease. Aims of this study were to determine arterial compliance parameters in type 1 diabetes (T1D) patients as an expression of early pre-clinical endothelial dysfunction and to evaluate the impact of glucose exposure parameters such as the duration of diabetes and glycosylated haemoglobin (HbA(1c)) on the risk of developing alterations in vascular compliance.


METHODS
23 patients with uncomplicated type 1 diabetes (mean age: 32.78 +/- 9.06 years, mean disease duration: 10.78 +/- 7.51 years, mean HbA(1c) levels: 7.7 +/- 1.9) and 26 age- and sex-matched healthy subjects (mean age: 32.3 +/- 8.51 years) were recruited. In these subjects, we evaluated arterial compliance by calibrated tonometry (HDI/Pulsewave() CR-2000). Parameters included the following: large artery elasticity (C1), small artery elasticity (C2), systemic vascular resistance (SVR) and total vascular impedance (TVI).


RESULTS
Patients with longer duration of T1D (>10 years) showed significant alterations in C2 (4.97 +/- 2.7 mL/mmHg x 100) and in SVR (1464.67 +/- 169.16 dina x s x cm(-5)) when compared with both healthy individuals (C2: 8.28 +/- 2.67 mL/mmHg x 100, p = 0.001; SVR: 1180.58 +/- 151.55 dina x s x cm(-5), p = 0.01) and patients with recent-onset disease (<or=10 years) (C2: 10.02 +/- 3.6 mL/mmHg x 100, p < 0.001; SVR: 1124.18 +/- 178.5 dina x s x cm(-5), p < 0.000). Both disease duration and HbA(1c) independently predicted impaired arterial compliance.


CONCLUSIONS
Young adult T1D patients with no signs of disease complication have detectable vessel wall abnormalities, particularly of small arteries, suggestive of hyperglycaemia-related early endothelial dysfunction.
UOC Medicina Interna E, Dipartimento di Clinica e Terapia Medica, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
I
I
Barchetta
L
L
Sperduti
G
G
Germanò
S
S
Valiante
A
A
Vestri
A
A
Fraioli
M G
MG
Baroni
M G
MG
Cavallo
D000328:Adult; D001158:Arteries / Q000503:physiopathology*; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D018618:Echocardiography, Doppler, Color; D004548:Elasticity; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006439:Hemodynamics; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D012307:Risk Factors; D017539:Tunica Intima / Q000503:physiopathology; D055815:Young Adult
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human