title: Subclinical Inflammation and Endothelial Dysfunction in Young Patients with Diabetes: A Study from United Arab Emirates.
abstract: BACKGROUND
  The impact of obesity and dyslipidemia on cardiovascular health in adolescents and young adults with diabetes is incompletely understood. This study evaluated the effects of these co-morbidities on markers of inflammation and endothelial dysfunction in young patients with the disease.
  
  
  METHODS
  The study investigated sets of inflammatory, endothelial, and adipocyte biomarkers in 79 patients with type 1 diabetes, 55 patients with type 2 diabetes, and 47 controls.
  
  
  RESULTS
  Mean (±SD) age was 20±6 y (median = 17, range = 12-31). Patients with diabetes had higher levels of cytoadhesive molecules (sICAM-1 and sVCAM-1, p<0.001), adiponectin (p<0.001), and haptoglobin (p = 0.023). Their heart rate variability assessment revealed lower standard deviation of beat-to-beat intervals and lower total power (p≤0.019), reflecting autonomous nervous dysfunction. Hemoglobin A1c >8.0% (estimated average blood glucose >10 mmol/L) was associated with higher adiponectin (p<0.001) and obesity was associated with lower adiponectin (p<0.001); thus, obesity damped the effect of hyperglycemia on adiponectin. Obesity was associated with higher sICAM-1 (p≤0.015), tumor necrosis factor-α (TNFα), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP), p<0.001. Similarly, high-density lipoprotein (HDL) <1.02 mmol/L was associated with higher sICAM-1, TNFα, IL-6, and hsCRP (p≤0.009) and lower adiponectin (p<0.001). Adiponectin correlated negatively with the inflammatory biomarkers in patients with diabetes.
  
  
  CONCLUSIONS
  Subclinical inflammation and endothelial dysfunction are common among young patients with diabetes. Poor diabetes control is associated with higher adiponectin. Obesity and dyslipidemia are associated with lower adiponectin and higher inflammatory and endothelial biomarkers. Intuitively, these predictors of cardiovascular disease are amenable to proper glycemic control, nutritional choices, and regular exercise.
authors.affiliation: Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: Elhadi H
authors.initials: EH
authors.lastname: Aburawi
authors.affiliation: Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: Juma
authors.initials: J
authors.lastname: AlKaabi
authors.affiliation: Department of Mathematics, College of Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: Taoufik
authors.initials: T
authors.lastname: Zoubeidi
authors.affiliation: Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Shehab
authors.affiliation: Department of Internal Medicine, Imperial College London Abu Dhabi, Abu Dhabi, United Arab Emirates.
authors.forename: Nader
authors.initials: N
authors.lastname: Lessan
authors.affiliation: Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: Awad
authors.initials: A
authors.lastname: Al Essa
authors.affiliation: Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: Javed
authors.initials: J
authors.lastname: Yasin
authors.affiliation: Cleveland Clinic, Abu Dhabi, United Arab Emirates.
authors.forename: Hussain
authors.initials: H
authors.lastname: Saadi
authors.affiliation: Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
authors.forename: Abdul-Kader
authors.initials: AK
authors.lastname: Souid
mesh_terms: D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006441:Hemoglobin A / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009765:Obesity / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014479:United Arab Emirates; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D055815:Young Adult
chemical_list: D052242:Adiponectin; D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D006441:Hemoglobin A