Background: The prevalence of macrovascular complications is probably underestimated in children with type 1 diabetes (T1D). Arterial stiffness (AS) represents a subclinical marker of CV risk. The most validated non-invasive method for AS measurement is pulse wave velocity (PWV). There are limited numbers of studies with PWV on children with T1D.
Aim: Our aim was to assess the relationship between AS and parameters associated with metabolic control in children with T1D.
Patients and methods: 59 children with T1D were examined (30 males, 51%) aged 919 years (median 16 years), with duration of T1D 217 years (median 9 years). 26 (44%) of them were treated with insulin pump (CSII). PWV was measured as the carotid-femoral pulse transmission time. The velocity adjusted for gender, age, heart rate and mean arterial pressure was expressed in normative percentiles using published paediatric references. The mean HbA1c from all patients assessed from last 24 months ranged from 50 to 119 mmol/mol IFCC (median 74 mmol/mol). 44 (75%) of all patients have evaluated ABPM using standard procedures, 16 from them (36%) children were hypertonic (included masked hypertension). Non-parametric test and a multiple regression analysis were used to compare the PWV percentiles and parameters associated with metabolic control.
Results: Significant association between PWV percentiles and HbA1c levels (P<0.01) and both systolic and diastolic blood pressure (P<0.05) was found. Duration of diabetes, lipids profile and insulin treatment mode were not associated with PWV. In multivariable analysis the most significant variable associated with increased PWV was HbA1c (P=0.0087) followed by 24 h systolic blood pressure SDS (P=0.0187).
Conclusion: The finding of increased PWV in poorly controlled T1D children is in accordance with the hypothesis of increased AS as an early predictor of CV risk.
Funding: The work was supported by grant IGA No 5300.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology