Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Cohen, Pinhas / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Feihong / Mericq, Veronica / Roth, Christian / Toppari, Jorma

Editorial Board Member: Battelino, Tadej / Buyukgebiz, Atilla / Cassorla, Fernando / Chrousos, George P. / Cutfield, Wayne / Fideleff, Hugo L. / Hershkovitz, Eli / Hiort, Olaf / LaFranchi, Stephen H. / Lanes M. D., Roberto / Mohn, Angelika / Root, Allen W. / Rosenfeld, Ron G. / Werther, George / Zadik, Zvi

12 Issues per year


IMPACT FACTOR 2016: 1.233

CiteScore 2016: 1.09

SCImago Journal Rank (SJR) 2016: 0.527
Source Normalized Impact per Paper (SNIP) 2016: 0.602

Online
ISSN
2191-0251
See all formats and pricing
More options …
Volume 27, Issue 1-2 (Jan 2014)

Issues

Detection of vascular risk markers in children and adolescents with type 1 diabetes

Heves Kırmızıbekmez
  • Corresponding author
  • Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ayla Güven
  • Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Metin Yıldız
  • Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Fatma Dursun
  • Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nurcan Cebeci
  • Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Suna Hancili
  • Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrinology, Istanbul, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2013-08-14 | DOI: https://doi.org/10.1515/jpem-2013-0046

Abstract

Objectives: Type 1 diabetes is a chronic disease that causes persistent vascular injury. This study investigates the benefits of surrogate markers in early detection of vascular injury in children and adolescents with type 1 diabetes.

Methods: Eighty-four patients (35 male, 49 female) with type 1 diabetes for 5 or more years were included. Serum lipid profile, plasminogen activator inhibitor-1 (PAI-1), lipoprotein (a) (Lpa) and homocystein, were investigated. Patients were divided into two groups according to the duration of diabetes. Patients with and without microvascular complications were also compared.

Results: Microvascular complications were present in 14 out of 48 patients in group-1 (29.1%; duration of diabetes: 5–10 years) and in 7 out of 36 patients in group-2 (19.4%; duration of diabetes: >10 years). Serum homocystein, Lpa, PAI-1 and serum lipids were not correlated with the duration of diabetes. Significantly increased triglyceride (TG) and HbA1C levels were associated with the presence of microvascular complications.

Conclusion: Providing good glycemic control is very important for preventing vascular injury in children and adolescents with type 1 diabetes. It seems that traditional vascular surrogate markers like LDL/HDL ratio, triglycerides and HbA1C level correspond more to microvascular complications than newly defined surrogate markers that are not commonly available.

Keywords: children and adolescents; type 1 diabetes; vascular complications

References

  • 1.

    Short KR, Blackett PR, Gardner AW, Copeland KC. Vascular health in children and adolescents: effects of obesity and diabetes. Vasc Health Risk Manag 2009;5:973–90.Google Scholar

  • 2.

    Creager MA, Luscher TF, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy. Circulation 2003;108:1527–32.CrossrefPubMedGoogle Scholar

  • 3.

    Hashemi M, Saadat M, Behjati M, Kelishadi R. Comparison of serum apolipoprotein levels of diabetic children and healthy children with or without diabetic parents. Cholesterol 2012. DOI 10.1155/2012/490381.PubMedCrossrefGoogle Scholar

  • 4.

    Atabek ME, Özkul Y, Eklioğlu BS, Kurtoğlu S, Baykara M. Association between apolipoprotein E polymorphism and subclinic atherosclerosis in patients with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol 2012;4:8–13.CrossrefGoogle Scholar

  • 5.

    Peña AS, Couper JJ, Harrington J, Gent R, Fairchild J, et al. Hypoglycemia, but not glucose variability, relates to vascular function in children with type 1 diabetes. Diabetes Technol Ther 2012;14:457–62.CrossrefPubMedGoogle Scholar

  • 6.

    Sibal L, Agarwal SC, Schwedhelm E, Lüneburg N, Böger RH, et al. A study of endothelial function and circulating asymmetric dimethylarginine levels in people with Type 1 diabetes without macrovascular disease or microalbuminuria. Cardiovasc Diabetol 2009;8:27.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 7.

    Ray JG. Meta-analysis of hyperhomocysteinemia as a risk factor for venous thromboembolic disease. Arch Intern Med 1998;158:2101.Google Scholar

  • 8.

    Palabrica TM, Liu AC, Aronovitz MJ, Furie B, Lawn RM, et al. Antifibrinolytic activity of apolipoprotein(a) in vivo: human apolipoprotein(a) transgenic mice are resistant to tissue plasminogen activator-mediated thrombolysis. Nat Med 1995;1:256.CrossrefPubMedGoogle Scholar

  • 9.

    Głowińska B, Urban M, Koput A, Galar M. Selected new atherosclerosis risk factors and markers of fibrinolysis in children and adolescents with obesity, hypertension and diabetes. Przegl Lek 2003;60:12–17.PubMedGoogle Scholar

  • 10.

    Van Dam RM, Willett WC, Manson JE, Hu FB. The relationship between overweight in adolescence and premature death in women. Ann Intern Med 2003;145:91.Google Scholar

  • 11.

    Bjørge T, Engeland A, Tverdal A, Smith GD. Body mass index in adolescence in relation to cause-specific mortality: a follow-up of 230,000 Norwegian adolescents. Am J Epidemiol 2008;168:30–7.Web of ScienceGoogle Scholar

  • 12.

    Must A, Phillips SM, Naumova EN. Occurrence and timing of childhood overweight and mortality: findings from the Third Harvard Growth Study. J Pediatr 2012;160:743.Web of ScienceGoogle Scholar

  • 13.

    Adult Treatment Panel III: Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection evaluation, and treatment of high blood cholesterol in adults. J Am Med Assoc 2001;285:2486–97.Google Scholar

  • 14.

    Dorchy H. Screening for subclinical complications in children and adolescents with type 1 diabetes: experience acquired in Brussels. Rev Med Brux 2010;31:87–108.Google Scholar

  • 15.

    Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G. Incidence Trends For Childhood Type 1 Diabetes in Europe During 1989–2003 and Predicted New Cases 2005–2020: A Multicentre Prospective Registration Study. Lancet 2009;373:2027–33.Web of ScienceGoogle Scholar

  • 16.

    Kubin M, Tossavainen P, Hannula V, Lahti S, Haulata N, et al. Prevalence of retinopathy in Finnish children and adolescents with type 1 diabetes: a cross-sectional population-based retrospective study (Abstract). Arch Dis Child 2011;96:963–8.CrossrefWeb of ScienceGoogle Scholar

  • 17.

    Al-Agha A, Ocheltree A, Hakeem A. Metabolic control in children and adolescents with insulin-dependent diabetes mellitus at king abdul-aziz university hospital. J Clin Res Pediatr Endocrinol 2011;3:202–7.Google Scholar

  • 18.

    Walsh MG, Zgibor J, Borch-Johnsen K, Orchard TJ. A multinational assessment of complications in type 1 diabetes: the DiaMond substudy of complications (DiaComp) Level 1. Diab Vasc Dis Res 2006;3:84–92.CrossrefGoogle Scholar

  • 19.

    Ramachandran A, Snehalatha C, Sasikala R,Satyavani K, Vijay V. Vascular complications in young Asian Indian patients with type 1 diabetes mellitus. Diabetes Res Clin Pract 2000;48:51–6.PubMedCrossrefGoogle Scholar

  • 20.

    Molitch ME, Steffes MW, Cleary PA, Nathan DM. Baseline analysis of renal function in the Diabetes Control and Complications Trial. The Diabetes Control and Complications Trial Research Group. Kidney Int 1993;43:668.PubMedCrossrefGoogle Scholar

  • 21.

    Vargas RB, Mangione CM, Asch S. Can a Chronic Care Model Collaborative Reduce Heart Disease Risk in Patients with Diabetes? J Gen Int Med 2007;22:215–22.CrossrefGoogle Scholar

  • 22.

    Laakso M. Cardiovascular Disease in Type 2 Diabetes from Population to Man to Mechanisms. Diabetes Care 2010;33:442–9.Web of ScienceCrossrefGoogle Scholar

  • 23.

    Hadjadj S, Duly-Bouhanick B, Bekherraz A, Brldoux F, Gallois Y, et al. Serum triglycerides are a predictive factor for the development and the progression of renal and retinal complications in patients with type 1 diabetes. Diabetes Metab 2004;30:43–51.PubMedCrossrefGoogle Scholar

  • 24.

    Tokgözoğlu SL, Alikaşifoğlu M, Atalar E. Homosistein ve MTHFR genotipinin koroner arter hastalığı risk ve yaygınlığının belirlenmesindeki önemi. Türk Kardiyol Dern Arş 1999;27:598–603 (Turkish).Google Scholar

  • 25.

    Aksoy M, Öç M, Aksoy ŞN, Koldaş M, Mihmanlı MB, et al. Bir Türk kohortunda plazma homosistein, folat ve B12 vitamini düzeyinin koroner arter hastalığı risk faktörü olarak önemi. Türk Kardiyol Dern Arş 2000;28:481–8 (Turkish).Google Scholar

  • 26.

    Aksoy ŞN, Geyikli İ, Saygılı Eİ. Sağlıklı Kişilerde Plazma Homosistein Düzeyinin Belirleyicileri. Türk Biyokimya Dergisi [Turkish Journal of Biochemistry] 2006;31:175–181 (Turkish).Google Scholar

  • 27.

    Greenlund KJ, Srinivasan SR, Xu JH, Dalferes ES, Myers L, et al. Plasma homocysteine distribution and its association with parental history of coronary artery disease in black and white children: the Bogalusa Heart Study. Circulation 1999;99:2144–2149.PubMedCrossrefGoogle Scholar

  • 28.

    Pratte KA, Baron AE, Ogden LG, Hassell KL, Rewers M, et al. Plasminogen activator inhibitor-1 is associated with coronary artery calcium in Type 1 diabetes. J Diabetes Complications 2009;23:387–93.CrossrefWeb of ScienceGoogle Scholar

  • 29.

    Velusami T, Jain SK. Effects of high glucose and ketosis (acetoacetate, ss-hydroxybutyrate) on PAI-1 secretion in human umbilical vascular endothelial cells. Clin Appl Thromb Hemost 2011;17:288–92.Web of ScienceCrossrefGoogle Scholar

About the article

Corresponding author: Dr. Heves Kırmızıbekmez, Göztepe Educational and Research Hospital, Clinics of Pediatric Endocrinology, Dr Erkin Caddesi, Kadıköy, Istanbul, Turkey, Phone: +90 216 3910680 (1374), Fax: +90 216 3910690, E-mail:


Received: 2012-11-28

Accepted: 2013-07-16

Published Online: 2013-08-14

Published in Print: 2014-01-01


Citation Information: Journal of Pediatric Endocrinology and Metabolism, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0046.

Export Citation

©2014 by Walter de Gruyter Berlin Boston. Copyright Clearance Center

Comments (0)

Please log in or register to comment.
Log in