Gourgari Evgenia, Dabelea Dana, Rother Kristina
Department of Pediatrics, Georgetown University, Washington DC, USA.
Section on Endocrinology and Genetics, Program on Developmental Endocrinology & Genetics (PDEGEN) and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, USA.
Curr Diab Rep. 2017 Nov 3;17(12):134. doi: 10.1007/s11892-017-0968-y.
Patients with type 1 diabetes have increased risk for cardiovascular disease. The purpose of this review is to examine the following: i) current evidence for subclinical cardiovascular disease (CVD) in children with type 1 diabetes (T1DM) ii) known modifiable risk factors for CVD and their relationship to subclinical CVD in this population iii) studies that have addressed these risk factors in order to improve CVD outcomes in children with T1DM RECENT FINDINGS: Subclinical CVD presents in children as increased carotid intima-media thickness, increased arterial stiffness, and endothelial and myocardial dysfunction. Modifiable risk factors for CVD include hyperglycemia, hyperlipidemia, obesity, hypertension, depression, and autonomic dysfunction. Very few randomized controlled studies have been done in children with T1DM to examine how modification of these risk factors can affect their CVD. Children with T1DM have subclinical CVD and multiple modifiable risk factors for CVD. More research is needed to define how modification of these factors affects the progression of CVD.
1型糖尿病患者患心血管疾病的风险增加。本综述的目的是研究以下内容：i）1型糖尿病（T1DM）儿童亚临床心血管疾病（CVD）的现有证据；ii）已知的可改变的CVD危险因素及其与该人群亚临床CVD的关系；iii）为改善T1DM儿童的CVD结局而针对这些危险因素进行的研究。最新发现：亚临床CVD在儿童中表现为颈动脉内膜中层厚度增加、动脉僵硬度增加以及内皮和心肌功能障碍。CVD的可改变危险因素包括高血糖、高脂血症、肥胖、高血压、抑郁和自主神经功能障碍。在T1DM儿童中进行的随机对照研究很少，以检验改变这些危险因素如何影响他们的CVD。T1DM儿童存在亚临床CVD和多种可改变的CVD危险因素。需要更多研究来确定改变这些因素如何影响CVD的进展。
