Endocrinology and Diabetes Department, University of Adelaide, Women's and Children's Hospital, 72 King William Rd N, Adelaide, SA 5006, Australia.
J Pediatr. 2010 Feb;156(2):237-41. doi: 10.1016/j.jpeds.2009.08.036. Epub 2009 Oct 23.
To compare aortic intima media thickness (aIMT) to carotid intima media thickness (cIMT) as a marker of early atherosclerosis in children with type 1 diabetes mellitus and to examine the associations of aIMT to known cardiovascular risk factors.
66 children with type 1 diabetes mellitus (age, 14.1 +/- 2.5 years; 37 male) and 32 healthy control subjects (age, 14.2 +/- 3 years; 15 male) underwent assessment of vascular structure (cIMT and aIMT) and vascular function (flow mediated dilatation [FMD] and glyceryl trinitrate induced dilatation [GTN]). Fasting blood tests were taken to measure levels of hemoglobin A1c, high sensitive C reactive protein, total homocyst(e)ine, serum folate, red cell folate, and lipids.
aIMT, but not cIMT, was significantly greater in the children with type 1 diabetes mellitus than in control subjects (P < .001). In children with type 1 diabetes mellitus, aIMT correlated with glycosylated hemoglobin (r = 0.31, P = .01) and was independently associated with age (beta = 0.38, P = .001) and low-density lipoprotein cholesterol level (beta = 0.38, P = .001). Vascular function (GTN) was worse in children with type 1 diabetes mellitus who had an aIMT >95th percentile, as defined with the control subjects.
aIMT is an earlier marker than cIMT of preclinical atherosclerosis in children with type 1 diabetes mellitus and relates to known cardiovascular risk factors and metabolic control.
比较儿童 1 型糖尿病患者的主动脉内膜中层厚度（aIMT）与颈动脉内膜中层厚度（cIMT），作为早期动脉粥样硬化的标志物，并探讨 aIMT 与已知心血管危险因素的相关性。
66 例 1 型糖尿病患儿（年龄 14.1 ± 2.5 岁；37 名男性）和 32 名健康对照者（年龄 14.2 ± 3 岁；15 名男性）接受了血管结构（cIMT 和 aIMT）和血管功能（血流介导扩张 [FMD] 和硝酸甘油诱导扩张 [GTN]）评估。空腹采血检测糖化血红蛋白 A1c、高敏 C 反应蛋白、总同型半胱氨酸、血清叶酸、红细胞叶酸和血脂水平。
与对照组相比，1 型糖尿病患儿的 aIMT 显著更高（P <.001），但 cIMT 无显著差异。在 1 型糖尿病患儿中，aIMT 与糖化血红蛋白呈正相关（r = 0.31，P =.01），且与年龄（β = 0.38，P =.001）和低密度脂蛋白胆固醇水平（β = 0.38，P =.001）独立相关。aIMT > 对照组 95%百分位数的 1 型糖尿病患儿的血管功能（GTN）更差。
与 cIMT 相比，aIMT 是儿童 1 型糖尿病患者亚临床动脉粥样硬化的早期标志物，与已知心血管危险因素和代谢控制相关。
