Nascimento Antonella Márcia Mercadante de Albuquerque do, Sequeira Inês Jorge, Vasconcelos Daniel França, Gandolfi Lenora, Pratesi Riccardo, Nóbrega Yanna Karla de Medeiros
Programa de Pós-Graduação em Ciências Médicas, Universidade de Brasília (UnB), Campus Universitário Darcy Ribeiro, Brasília, DF, Brasil.
Hospital Universitário de Brasília, Campus Universitário Darcy Ribeiro, Brasília, DF, Brasil.
Arch Endocrinol Metab. 2017 Sept-Oct;61(5):476-483. doi: 10.1590/2359-3997000000271. Epub 2017 Jun 26.
The purpose of this study was to verify the presence of endothelial dysfunction and initial structural atherosclerotic changes in children with Type 1 diabetes mellitus (T1DM).
The study population comprised 31 diabetic children aged 6 to 12 years, divided into two subgroups according to the duration of the T1DM diagnosis: subgroup 1, with less than 5 years elapsed since diagnosis, and subgroup 2, with more than 5 years elapsed since diagnosis. The control group comprised 58 age-matched healthy children. Ultrasonographic techniques were used to measure the flow-mediated dilatation (FMD) of the brachial artery and the intima-media thickness (IMT) of the carotid arteries.
Children with T1DM with longer disease duration showed significantly decreased mean values of FMD compared with those in the control group. No significant differences between the groups were found in relation to IMT. The FMD percentage presented a moderate negative correlation with glycated hemoglobin (HbA1c) and fasting glucose levels.
Our findings suggest that endothelial dysfunction may be already present in children with 5 years or more elapsed since diagnosis, even in the absence of atherosclerotic structural changes. The decreased vasodilation response correlated with hyperglycemia.
本研究旨在验证1型糖尿病（T1DM）患儿是否存在内皮功能障碍和早期动脉粥样硬化结构改变。
研究对象包括31名6至12岁的糖尿病患儿，根据T1DM诊断时间分为两个亚组：亚组1，诊断后病程小于5年；亚组2，诊断后病程大于5年。对照组包括58名年龄匹配的健康儿童。采用超声技术测量肱动脉的血流介导的扩张（FMD）和颈动脉的内膜中层厚度（IMT）。
病程较长的T1DM患儿与对照组相比，FMD平均值显著降低。两组在IMT方面未发现显著差异。FMD百分比与糖化血红蛋白（HbA1c）和空腹血糖水平呈中度负相关。
我们的研究结果表明，即使在没有动脉粥样硬化结构改变的情况下，诊断后5年或更长时间的患儿可能已经存在内皮功能障碍。血管舒张反应降低与高血糖相关。
