Evaluation of Arterial Stiffness in Children with Type 1 Diabetes Mellitus Using Speckle Tracking Carotid Strain Ultrasonography: Do Atherosclerotic Changes Begin in Childhood?

Mustafa Gök; Sevim Reyhan Deveci; Sercan Öztürk; Tolga Ünüvar; Ahmet Anık

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ESPE Abstracts (2024) 98 RFC1.5

ESPE2024 Rapid Free Communications Diabetes and Insulin (6 abstracts)

Evaluation of Arterial Stiffness in Children with Type 1 Diabetes Mellitus Using Speckle Tracking Carotid Strain Ultrasonography: Do Atherosclerotic Changes Begin in Childhood?

Mustafa Gök ¹ , Reyhan Deveci Sevim ² , Sercan Öztürk ³ , Tolga Ünüvar ² & Ahmet Anık ²

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¹Aydın Adnan Menderes University Faculty of Medicine, Department of Radiology, Aydın, Turkey. ²Aydın Adnan Menderes University Faculty of Medicine, Division of Pediatric Endocrinology, Aydın, Turkey. ³Aydın Adnan Menderes University Faculty of Medicine, Department of Pediatrics, Aydın, Turkey

Objective: The aim of this study was to evaluate the effectiveness of the Speckle Tracking Carotid Strain (STKS) ultrasonography technique, which allows the measurement of arterial stiffness and strain parameters, in the detection of early atherosclerotic findings in children with type 1 diabetes mellitus (T1DM).

Materials and Methods: Children aged 7-18 years with T1DM and no other comorbidities were included in the study. Healthy children of the same age and gender were included as the control group. Children with T1DM were also analyzed by subdividing them into good (<7%), moderate (7-9%) and poor (≥9%) metabolic control according to their mean HbA1c values in the last year.

Results: A total of 165 children (90 T1DM and 75 control group) were included in the study. There were no differences in age, gender, height, body weight and body mass index between the T1DM and healthy groups. Waist circumference and systolic blood pressure were higher in the T1DM group (P = 0.016 and P <0.001, respectively). Fasting glucose, HbA1c, protein/creatinine ratio in spot urine, total cholesterol and triglyceride levels were higher in the T1DM group compared to the healthy group (P <0,001, P <0,001, P = 0,004, P = 0,001, P <0,001, respectively). Beta Stiffness Index (BSI) was higher, Arterial Compliance (AC) was lower, Arterial Distensibility (AD) was lower, Elastic Modulus (EM) was higher, and Pulse Wave Velocity (PWV) was higher in transverse and longitudinal measurements in the diabetic group (P <0.001). In Strain parameters, Displacement was found to be lower in transverse and circumferential planes (P = 0.031; P = 0.033, respectively). There were no differences between Strain and Strain Rate measurements. Metabolic control was good in 25.6% (n = 23), moderate in 51.1% (n = 46) and poor in 23.3% (n = 21) of the patients with diabetes. While there was no difference in stiffness parameters according to diabetes control, strain parameters were lower in patients with poor metabolic control (P <0.05). All stiffness parameters (BSI, AC, AD, EM, PWV) and two strain parameters (displacement and strain%) were correlated with HbA1c (P <0.05).

Conclusion: Children with type 1 diabetes mellitus had increased arterial stiffness parameters compared to healthy children. Moreover, patients with poor metabolic control had worse stiffness parameters.