title: Reduced brachial artery distensibility in patients with type 1 diabetes.
abstract: In patients with type 1 diabetes mellitus (T1D), cardiovascular disease (CVD) events are more common and occur earlier in life than in non-diabetics. Reduced brachial artery distensibility (BrachD) is an independent risk factor for development of CVD. Our aim was to determine if adults with T1D have lower BrachD compared to adults without diabetes and also to determine how age and gender affect the relationship of BrachD with T1D status.
  
  
  
  BrachD was measured using the Dynapulse instrument in 829 participants (352 with T1D, 477 non-diabetics). An ANCOVA model was used to test the association of BrachD with age, sex, and T1D, and the significance of an age*sex*T1D interaction.
  
  
  
  Mean BrachD was lower in T1D patients vs. controls (6.43±1.46 vs. 7.16±1.48 % change per mmHg, p<0.0001). In a model adjusted for age, T1D, and sex, the interaction of age*T1D*sex was significant (p=0.0045). Younger women both with and without T1D had higher BrachD than men with and without T1D, but older women with and without T1D had lower BrachD compared to older men with and without T1D. Women with T1D had a steeper decline in BrachD with age than nondiabetic women.
  
  
  
  BrachD is lower in T1D patients than in non-diabetics, indicating increased vascular stiffness. Younger females have higher BrachD than males, but the decline with age in BrachD is steeper for women, particularly among those with T1D. BrachD may be an inexpensive, non-invasive method to ascertain increased CVD risk in this population.
authors.affiliation: Medical Faculty, Linköping University, 582 25, Linköping, Sweden.
authors.forename: Philip
authors.initials: P
authors.lastname: Ljunggren
authors.affiliation: Barbara Davis Center for Childhood Diabetes, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
authors.affiliation: Medical Faculty, Linköping University, 582 25, Linköping, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Johansson
authors.affiliation: Div of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, 582 25, Linköping, Sweden.
authors.forename: Johnny
authors.initials: J
authors.lastname: Ludvigsson
authors.affiliation: Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Pyle
authors.affiliation: Barbara Davis Center for Childhood Diabetes, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Sippl
authors.affiliation: Barbara Davis Center for Childhood Diabetes, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: R Paul
authors.initials: RP
authors.lastname: Wadwa
authors.affiliation: Barbara Davis Center for Childhood Diabetes, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Electronic address: Janet.Snell-Bergeon@ucdenver.edu.
authors.forename: Janet
authors.initials: J
authors.lastname: Snell-Bergeon
mesh_terms: D000328:Adult; D000367:Age Factors; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D003120:Colorado / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012306:Risk; D012737:Sex Factors; D061205:Vascular Calcification / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D018924:Vascular Capacitance; D059289:Vascular Stiffness; D055815:Young Adult
keywords: Arterial stiffness; Brachial artery distensibility; Cardiovascular disease; Coronary artery calcium; Type 1 diabetes