title: Suboptimal glycaemic control enhances the risk of impaired prothrombotic state in youths with type 1 diabetes mellitus.
abstract: OBJECTIVE
  To estimate markers of prothrombotic state and endothelial dysfunction in youths with type 1 diabetes mellitus (T1DM) and investigate possible associations with anthropometric/demographic data, glycaemic control and lipid profile.
  
  
  METHODS
  In a cross-sectional design, we recruited 155 youths with T1DM and determined levels of plasminogen activator inhibitor-1-antigen (PAI-1-Ag), von Willebrand factor-antigen (vWF-Ag), fibrinogen (FB), lipids and glycosylated haemoglobin (HbA1c).
  
  
  RESULTS
  Of all the participants, 76 (49%) had increased levels of at least one of prothrombotic factors. Suboptimal glycaemic control was associated with a worse lipid profile and an eightfold increased risk of elevated vWF-Ag levels. Higher vWF-Ag concentrations were also correlated with impaired lipid profile and increased HbA1c values, whereas PAI-1-Ag was positively correlated only with triglyceride levels. After adjustment for potential confounders, only HbA1c contributed independently to the variation in vWF-Ag levels.
  
  
  CONCLUSIONS
  Impaired prothrombotic state and consequently endothelial dysfunction are present in youths with T1DM, representing a cumulative risk factor for future cardiovascular disease (CVD). Achievement and maintenance of euglycaemia and normolipidaemia are crucial to decelerate progress of this process.
authors.affiliation: 4th Department of Pediatrics, Faculty of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kyrgios
authors.forename: Ioanna
authors.initials: I
authors.lastname: Maggana
authors.forename: Styliani
authors.initials: S
authors.lastname: Giza
authors.forename: Dorothea
authors.initials: D
authors.lastname: Stergidou
authors.forename: Konstantina
authors.initials: K
authors.lastname: Mouzaki
authors.forename: Eleni P
authors.initials: EP
authors.lastname: Kotanidou
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Papadakis
authors.forename: Assimina
authors.initials: A
authors.lastname: Galli-Tsinopoulou
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D019851:Thrombophilia / Q000097:blood* / Q000150:complications; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D005340:Fibrinogen; D006442:Glycated Hemoglobin; D017395:Plasminogen Activator Inhibitor 1; D014841:von Willebrand Factor; C051321:SERPINE1 protein, human; C517652:hemoglobin A1c protein, human
keywords: Children and adolescents; fibrinogen; plasminogen activator inhibitor-1-antigen; type 1 diabetes mellitus; von Willebrand factor-antigen