title: Impaired endothelial function in preadolescent children with type 1 diabetes.
abstract: OBJECTIVE
  We evaluated the prevalence of endothelial dysfunction as measured by flow-mediated dilatation (FMD) of the brachial artery and carotid intima-media thickness (c-IMT) in relationship to vascular inflammatory biomarkers in preadolescent children with type 1 diabetes.
  
  
  METHODS
  We studied 21 type 1 diabetic children (aged 8.3 ± 0.3 years with diabetes duration of 4.3 ± 0.4 years) and 15 group-matched healthy siblings (aged 7.6 ± 0.3 years). Fasting plasma glucose (FPG), lipid profile, HbA(1c), high-sensitivity C-reactive protein (hs-CRP), fibrinogen, homocysteine, and erythrocyte (red blood cell [RBC]) folate were evaluated in all subjects. Each subject underwent c-IMT and brachial artery FMD percentage (FMD%) measurements using high-resolution vascular ultrasound.
  
  
  RESULTS
  Type 1 diabetic children had higher FPG (173.4 ± 7.9 mg/dL vs. 81.40 ± 1.7 mg/dL; P < 0.0001), HbA(1c) (8.0 ± 0.2% vs. 5.0 ± 0.1%; P < 0.0001), and hs-CRP (1.8 ± 0.3 vs. 0.70 ± 0.2; P = 0.017) than control children without significant differences in BMI, homocysteine, and fibrinogen levels; RBC folate content; and c-IMT between the groups. Children with type 1 diabetes had lower FMD% than control children (7.1 ± 0.8% vs. 9.8 ± 1.1%; P = 0.04), whereas c-IMT did not differ between groups.
  
  
  CONCLUSIONS
  Preadolescent children with type 1 diabetes and mean diabetes duration of 4 years displayed evidence of low-intensity vascular inflammation and attenuated FMD measurements. These data suggest that endothelial dysfunction and systemic inflammation, known harbingers of future cardiovascular risk, are present even in preadolescent children.
authors.affiliation: Department of Pediatric Endocrinology, Children’s Mercy Hospital, Kansas City, Missouri, USA.
authors.forename: Ghufran S
authors.initials: GS
authors.lastname: Babar
authors.forename: Hanaa
authors.initials: H
authors.lastname: Zidan
authors.forename: Michael E
authors.initials: ME
authors.lastname: Widlansky
authors.forename: Emon
authors.initials: E
authors.lastname: Das
authors.forename: Raymond G
authors.initials: RG
authors.lastname: Hoffmann
authors.forename: Marwan
authors.initials: M
authors.lastname: Daoud
authors.forename: Ramin
authors.initials: R
authors.lastname: Alemzadeh
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002097:C-Reactive Protein / Q000378:metabolism; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000378:metabolism / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005215:Fasting / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005492:Folic Acid / Q000378:metabolism; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D008297:Male; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000503:physiopathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose; D006710:Homocysteine; D005340:Fibrinogen; D002097:C-Reactive Protein; D005492:Folic Acid