Arterial stiffness in adolescents and young adults with and without type 1 diabetes: the SEARCH CVD study.
BACKGROUND
Arterial stiffness is a useful parameter to predict future cardiovascular disease.


OBJECTIVE
We sought to compare arterial stiffness in adolescents and young adults with and without type 1 diabetes (T1D) and explore the risk factors associated with the differences observed.


METHODS
Carotid-femoral pulse wave velocity (PWV), augmentation index (AI75), and brachial distensibility (BrachD) were measured in 402 adolescents and young adults with T1D (age 18.8 ± 3.3 yr, T1D duration 9.8 ± 3.8 yr) and 206 non-diabetic controls that were frequency-matched by age, sex, and race/ethnicity in a cross-sectional study. General linear models were used to explore variables associated with an increase in arterial stiffness after adjustment for demographic and metabolic covariates.


RESULTS
T1D status was associated with a higher PWV (5.9 ± 0.05 vs. 5.7 ± 0.1 m/s), AI75 (1.3 ± 0.6 vs. -1.9 ± 0.7%), and lower BrachD (6.2 ± 0.1 vs. 6.5 ± 0.1%Δ/mmHg), all p < 0.05. In multivariate models, age, sex, race, adiposity, blood pressure, lipids, and the presence of microalbuminuria were found to be independent correlates of increased arterial stiffness. After adjustment for these risk factors, T1D status was still significantly associated with arterial stiffness (p < 0.05).


CONCLUSIONS
Peripheral and central subclinical vascular changes are present in adolescents and young adults with T1D compared to controls. Increased cardiovascular risk factors alone do not explain the observed differences in arterial stiffness among cases and controls. Identifying other risk factors associated with increased arterial stiffness in youth with T1D is critical to prevent future vascular complications.
Department of Pediatrics, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, OH, USA.
Amy S
AS
Shah
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
R Paul
RP
Wadwa
Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA.
Dana
D
Dabelea
Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA.
Richard F
RF
Hamman
Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Ralph
R
D'Agostino
Northwest Lipid Research Laboratories, University of Washington, Seattle, WA, USA.
Santica
S
Marcovina
Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Stephen R
SR
Daniels
Department of Pediatrics, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, OH, USA.
Lawrence M
LM
Dolan
Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Nora F
NF
Fino
Department of Pediatrics, Cincinnati Children's Hospital and University of Cincinnati, Cincinnati, OH, USA.
Elaine M
EM
Urbina
D000293:Adolescent; D000328:Adult; D055109:Ankle Brachial Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D003120:Colorado / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009820:Ohio / Q000453:epidemiology; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness / Q000502:physiology*; D055815:Young Adult
arterial stiffness; pediatrics; type 1 diabetes; vascular disease