title: Adolescents and young adults with type 1 diabetes display a high prevalence of endothelial dysfunction.
abstract: OBJECTIVE
  Little is known about endothelial function in adolescents with type 1 diabetes, and we evaluated endothelial dysfunction, using reactive hyperaemia peripheral arterial tonometry (RH-PAT).
  
  
  METHODS
  This prospective, observational, 1-year study focused on 73 adolescents with type 1 diabetes, using multiple daily injections or continuous subcutaneous insulin infusion. The subjects were assessed using RH-PAT, body mass index, blood pressure, fasting lipid profile, glycated haemoglobin, insulin requirements and hours of physical exercise per week.
  
  
  RESULTS
  Endothelial dysfunction was observed in 56 patients (76.7%), with lower mean RH-PAT scores (1.26 ± 0.22 versus 2.24 ± 0.48, p < 0.0001) and higher glycated haemoglobin values at baseline (8.27 ± 1.24% versus 7.37 ± 0.54%, p = 0.006) and as a mean of the whole period since diagnosis (8.25 ± 1.22% versus 7.72 ± 0.82%, p = 0.034). A higher percentage of patients with endothelial dysfunction showed abnormal cardiac autonomic tests (p = 0.02) and were more sedentary, exercising <4 hours a week, than patients with normal endothelial function. After follow-up in 64/73 patients, we observed endothelial dysfunction in 81.8% of patients, despite a modest improvement in glycated haemoglobin.
  
  
  CONCLUSIONS
  Adolescents with type 1 diabetes displayed evidence of endothelial dysfunction. Good metabolic control (glycated haemoglobin ≤7.5%, 58 mmol/mol) and regular physical activity of at least 4 h a week might be protective.
authors.affiliation: Department of Pediatrics, Azienda Ospedaliera, University of Milano, "Ospedale Luigi Sacco", Milano, Italy.
authors.forename: A E
authors.initials: AE
authors.lastname: Scaramuzza
authors.forename: F
authors.initials: F
authors.lastname: Redaelli
authors.forename: E
authors.initials: E
authors.lastname: Giani
authors.forename: M
authors.initials: M
authors.lastname: Macedoni
authors.forename: V
authors.initials: V
authors.lastname: Giudici
authors.forename: A
authors.initials: A
authors.lastname: Gazzarri
authors.forename: A
authors.initials: A
authors.lastname: Bosetti
authors.forename: L
authors.initials: L
authors.lastname: De Angelis
authors.forename: G V
authors.initials: GV
authors.lastname: Zuccotti
mesh_terms: D000293:Adolescent; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000209:etiology; D008297:Male; D008365:Manometry; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D014463:Ultrasonography; D055815:Young Adult
keywords: Adolescence; Endothelial dysfunction; Insulin pump therapy; Multiple daily injections; Reactive hyperaemia index