title: Blood pressure disturbances and endothelial dysfunction markers in children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  Being the earliest step on the way to atherosclerosis, endothelial dysfunction is particularly escalated in diabetes. This study aimed at assessing endothelial dysfunction and blood pressure disturbances in young patients with type 1 diabetes mellitus (T1DM) and defining their interrelations.
  
  
  METHODS
  The study group comprised 52 children and adolescents aged 14.07 ± 3.03 years, with T1DM duration 5.13 ± 2.18 years. 20 healthy controls with similar age and sex distribution were included. Chosen serum biochemical markers of endothelial damage: intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), sE-selectin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) as well as ambulatory blood pressure monitoring (ABPM) were performed in all subjects.
  
  
  RESULTS
  Patients with T1DM displayed significantly higher concentrations of chosen markers of endothelial dysfunction compared to controls (sVCAM-1 (ng/ml): 951.56 ± 330.68 vs. 710.35 ± 162.12, TNF-α (pg/ml): 16.63 ± 8.32 vs. 9.41 ± 4.23, IL-6 (pg/ml): 3.38 ± 1.31 vs. 2.45 ± 0.81; p < 0.05). Within the study group subjects with an abnormal ABPM reading had significantly higher concentrations of sE-selectin compared with subjects with normal ABPM (in ng/ml: 45.71 ± 15.63 vs. 32.42 ± 11.95; p < 0.01). The study revealed a significant positive correlation between sE-selectin and systolic as well as diastolic pressure loads during the day period (respectively: r = 0.46, r = 0.60; p < 0.01).
  
  
  CONCLUSIONS
  Endothelium dysfunction may be present early in the course of T1DM in children and adolescents. It seems to be related with blood pressure disturbances which highlights the need to intensify treatment in this group of patients.
authors.affiliation: Upper-Silesia Child Health Center, ul. Medykow 16, 40-752 Katowice, Poland. Electronic address: lukaszmachnica@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Machnica
authors.affiliation: Dept. of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, ul. Medykow 16, 40-752 Katowice, Poland.
authors.forename: G
authors.initials: G
authors.lastname: Deja
authors.affiliation: Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, ul. Akademicka 16, 44-101 Gliwice, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Polanska
authors.forename: L
authors.initials: L
authors.lastname: Czupryniak
authors.forename: E
authors.initials: E
authors.lastname: Szymanska-Garbacz
authors.forename: J
authors.initials: J
authors.lastname: Loba
authors.affiliation: Dept. of Pediatrics, Endocrinology and Diabetes, Medical University of Silesia, ul. Medykow 16, 40-752 Katowice, Poland.
authors.forename: P
authors.initials: P
authors.lastname: Jarosz-Chobot
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D002648:Child; D048909:Diabetes Complications / Q000175:diagnosis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D012044:Regression Analysis; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D019040:E-Selectin; C573420:ICAM1 protein, human; D015850:Interleukin-6; C546936:SELE protein, human; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1
keywords: ABPM; Blood pressure; Endothelial dysfunction; Type 1 diabetes