ESPE Abstracts

Background: Type 1 diabetes is a risk factor for cardiovascular disease. Osteoprotegerin is a predictor of cardiovascular disease. Endothelial dysfunction is the earliest event in atherosclerosis and subsequent cardiovascular disease. Flow mediated dilation (FMD) of brachial artery can be used to detect endothelial dysfunction.

Objective and hypotheses: To assess FMD of brachial artery in Type 1 diabetes and its relation to serum osteoprotegerin level.

Method: Forty type 1 diabetic children were compared with 40 controls. All underwent anthropometric assessment, measurement of lipids, HbA1c, albumin: creatinine ratio, and serum osteoprotegerin. FMD of brachial artery was assessed by measuring brachial artery diameter at baseline (A) and at one minute after release of pressure (B). The absolute change in brachial artery diameter in mm (FMD (B – A)), and the delta change (Δ FMD)=(B – A)/A were estimated.

Results: The mean (SD) age of patients was 12.1 (4.2) years, mean (SD) diabetes duration was 4.5 (3.7) years. No significant difference in age, gender, height SDS, weight SDS, BMI SDS, waist circumference SDS, and mean blood pressure existed between patients and controls. Serum osteoprotegerin, total cholesterol, and LDL-Cholesterol were significantly higher while HDL-Cholesterol was significantly lower among patients (P < 0.05). Brachial artery diameter at 1 minute after release of pressure (B), absolute difference FMD (B – A), and Delta change (Δ FMD) in brachial artery diameter were significantly lower in patients (P < 0.001). No significant correlation existed between osteoprotegerin and brachial artery FMD (P > 0.05). LDL-Cholesterol negatively correlated with FMD (B – A), and Δ FMD (B – A) while osteoprotegerin positively correlated with triglycerides.

Conclusion: Endothelial dysfunction and risk of atherosclerosis exist early in children with type 1 diabetes. Early recognition of these events is important to prevent progression of atherosclerosis and cardiovascular disease at an early age.