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Licensed Unlicensed Requires Authentication Published by De Gruyter November 15, 2018

Arterial stiffness as a measure of cardiovascular risk in obese adolescents and adolescents with diabetes type 1

Kresimir Putarek, Ljiljana Banfic, Marijan Pasalic, Nevena Krnic, Anita Spehar Uroic and Natasa Rojnic Putarek ORCID logo

Abstract

Background

Cardiovascular disease (CVD) is the end result of vascular aging and atherosclerosis, having its origins in childhood. The aim of our study was to compare arterial stiffness (AS) and intima-media thickness (IMT) as markers of an early vascular damage between obese adolescents, adolescents with diabetes type 1 (T1D) and lean control subjects.

Methods

We analyzed AS and IMT in 68 obese adolescents (13.27±2.31 years), 42 adolescents with T1D (14.95±2.35 years) lasting over 5 years and 38 controls (15.02±1.94 years). AS (measured by pulse wave velocity [PWV], arterial compliance [AC] and β-stiffness) and IMT were assessed using an e-tracking ultrasound method.

Results

A significant difference between the groups was found for AC (p=0.022) and PWV (p=0.010), with the lowest compliance and higher velocities in T1D patients. When corrected for age, the difference in AC among the groups did not reach a statistical difference (p=0.059). Correlation analysis in the obese adolescents showed lower AC in females (p=0.041), with higher systolic blood pressure (SBP) (p=0.032). In T1D adolescents, disease duration was the strongest determinant of AS (AC p=0.028, β p=0.029 and PWV p=0.003), followed by body mass index (BMI; PWV p=0.008; β p=0.033), SBP (AC p<0.001; PWV p=0.023), diastolic BP (AC p=0.049; PWV p=0.048) and HbA1c (PWV p=0.048). No significant correlations were found for AS measures or IMT with sex, age, BMI, Tanner stage or BP levels in controls.

Conclusions

Early vascular damage is more pronounced in T1D adolescents than in obese or lean adolescents, which may emphasize the impact of hyperglycemia as a major threat for cardiovascular health.


Corresponding author: Natasa Rojnic Putarek, MD, PhD, Department of Paediatric Endocrinology and Diabetes, Zagreb University Hospital Centre, School of Medicine, Kispaticeva 12, Zagreb, Croatia, Phone: +385 1 2388-556, Fax: +385 1 2367 442

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-03-22
Accepted: 2018-10-08
Published Online: 2018-11-15
Published in Print: 2018-12-19

©2018 Walter de Gruyter GmbH, Berlin/Boston

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