ESPE2021 Free Communications Diabetes (6 abstracts)
Role of physical activity and sedentary behavior on early markers of cardiovascular disease in Canadian adolescents with and without type 1 diabetes: the CARDEA study
Soren Harnois-Leblanc 1,2,3 , Vanessa McNealis 1,4 , Matthias G Friedrich 5,6 , AndraeaVan Hulst 7 , Anne-Monique Nuyt 1,8 , Jean-Luc Bigras 1,8 , Tracie A. Barnett 1,9 , Andrea Benedetti 4 , Marie-Ève Mathieu 1,10 , Vicky Drapeau 11 , Marie-Pierre Sylvestre 2,3 & Mélanie Henderson 1,2,8
1Research Center of Sainte-Justine Hospital University Center, Montreal, Canada.;2Department of Preventive and Social Medicine, School of Public Health, University of Montreal, Montreal, Canada.;3Research Center of the Montreal Hospital University Center, Montreal, Canada.;4Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada.;5McGill University Health Centre, Montreal, Canada.;6Department of Medicine and Diagnostic Radiology, Faculty of Medicine, McGill University, Montreal, Canada.;7Ingram School of Nursing, McGill University, Montreal, Canada.;8Department of Pediatrics, Faculty of Medicine, University of Montreal, Montreal, Canada.;9Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Canada.;10School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.;11Department of Physical Activity, School of Education Sciences, Laval University, Quebec City, Canada
Background: Type 1 diabetes (T1D) is a risk factor for cardiovascular disease (CVD) and alterations may manifest as early as in adolescence. Increased physical activity and reduced sedentary behavior reduce the risk of CVD development in general adult populations, but knowledge is limited on their associations with early markers of CVD risk in pediatric T1D.
Objective: Estimate associations of physical activity and sedentary behavior with early markers of CVD in adolescents and test whether associations differ based on T1D status.
Methods: Cross-sectional study of 100 adolescents (14-18 yrs) with T1D recruited at the Sainte-Justine Hospital Diabetes Clinic (Montréal, Canada) and 97 age- and sex-matched controls. Arterial stiffness was measured by pulse-wave velocity (PWV). Endothelial function was assessed with a brachial flow-mediated dilation test and quantified with post-release velocity time integral (VTI) and acceleration. Cardiac magnetic resonance assessed ejection fraction, left ventricular mass indexed by height (LVMH), papillary mass and wall thickness. Moderate-to-vigorous physical activity (MVPA) and sedentary time were estimated with seven-day accelerometry. Recreational screen time and ethnicity were assessed by questionnaire. Weight and height were measured to compute body mass index z-scores (zBMI). Distinct multivariable linear regression models were estimated for each CVD marker, adjusting for T1D status, age, sex, ethnicity, zBMI, and screen time (MVPA models) or MVPA (sedentary and screen time models), and additionally systolic blood pressure z-score and heart rate in models including endothelial function and cardiac magnetic resonance markers. Interaction terms for exposures of interest and T1D status were tested.
Results: Adolescents with T1D had a lower LVMH than controls (previously reported), and higher PWV. Each 10 minutes/day increment in MVPA was associated with a higher LVMH (beta [95% CI]: 0.88 g/m [0.04; 1.72]) in all participants, with no difference across groups. The association between sedentary time and wall thickness differed depending on T1D status. Each supplemental hour/day of sedentary time among adolescents with T1D was associated with a 0.10 mm greater wall thickness, while in controls, sedentary time was associated with a 0.12 mm reduction in wall thickness (P interaction < 0.05). No other associations were noted in multivariable models.
Conclusion: Associations between sedentary behaviors and early markers of CVD differ between adolescents with T1D and healthy controls, sedentary time being possibly more deleterious in this vulnerable population. MVPA could potentially mitigate early CVD risk in adolescents.
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