title: HbA1c but not diabetes duration predicts increased arterial stiffness in adolescents with poorly controlled type 1 diabetes.
abstract: The prevalence of macrovascular complications is probably underestimated in children with type 1 diabetes (T1D). Arterial stiffness (AS) is a subclinical marker of cardiovascular (CV) risk. The most validated, non-invasive method for AS measurement is pulse wave velocity (PWV). Only a few PWV studies have been performed in children with T1D.
  
  
  
  To explore the risk factors associated with AS in adolescents with suboptimally controlled T1D.
  
  
  
  Seventy-seven adolescents with T1D were included (39 girls, 38 boys) in this study. The adolescents had a median age of 16 yr (IQR 14-17), median duration of T1D was 9 yr (IQR 6-16), and HbA1c 71 mmol/mol (median, IQR 62-81). PWV was measured as the carotid-femoral pulse transmission time and converted into standard deviation scores (SDS) (adjusted for gender and age) using normative values for children. The risk factors assessed were HbA1c, T1D duration, treatment modality, serum lipids, and blood pressure (BP) measured via ambulatory blood pressure monitoring (ABPM).
  
  
  
  The PWV did not differ from the reference data (median PWV was 5.1 m/s, i.e., -0.01 SDS). A significant positive association was observed between PWV-SDS and HbA1c (p = 0.001), total cholesterol (p = 0.003), LDL-cholesterol (p = 0.003), but not T1D duration (p = 0.78) according to the univariate analyses. In the multivariate model, the only significant variable that remained positively associated with PWV-SDS was HbA1c (p = 0.03).
  
  
  
  Most adolescents with suboptimally controlled T1D have normal mean PWV compared to a healthy reference population. Chronic hyperglycemia, not T1D duration, is the main predictor of AS in adolescents.
authors.affiliation: Department of Pediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Barbora
authors.initials: B
authors.lastname: Obermannova
authors.affiliation: Department of Pediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Petruzelkova
authors.affiliation: Department of Pediatrics, University Hospital and Medical Faculty, University of Ostrava, Ostrava, Czech Republic.
authors.forename: Terezie
authors.initials: T
authors.lastname: Sulakova
authors.affiliation: Department of Pediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Sumnik
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D018153:Czech Republic / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000517:prevention & control*; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006785:Hospitals, University; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D008297:Male; D015995:Prevalence; D063177:Pulse Wave Analysis; D012017:Referral and Consultation; D012307:Risk Factors; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: adolescents; arterial stiffness; blood pressure; pulse wave velocity; type 1 diabetes