Pós-Graduação Ciências Médicas, Faculdade Ciências Médicas-Minas Gerais (FCM-MG), Belo Horizonte, Brazil.
Ambulatório de Endocrinologia do Hospital João Paulo II, Belo Horizonte, Brazil.
Pediatr Diabetes. 2019 Mar;20(2):202-209. doi: 10.1111/pedi.12782. Epub 2018 Dec 27.
BACKGROUND/OBJECTIVE: Type 1 diabetes mellitus (DM1) presents important risk factors for cardiovascular events.
To compare the components of the aortic pulse wave (APW) and the hemodynamic parameters among children and adolescents with DM1 and healthy individuals.
This is a cross-sectional study, with 36 children and adolescents diagnosed with DM1 (11.9 ± 3.2 years) matched by sex and age with the control group (n = 36, 12.4 ± 2.9 years). The components of the APW and the hemodynamic parameters were evaluated non-invasively, using Mobil-O-Graph.
On the week of the evaluation, DM1 patients presented glycated hemoglobin (hemoglobin A1C [HbA1c]) of 9.48 ± 2.22% and fasting glycemia of 222.58 ± 93.22 mg/dL. Augmentation index (AIx@75), reflection coefficient, and augmentation pressure (AP) were significantly higher in the DM1 group (29.0 ± 9.7%, 63.0 ± 7.9, and 7.8 ± 2.7 mm Hg, respectively) compared with the control group (20.6 ± 7.9%, 53.4 ± 9.1 and 4.9 ± 2.1 mm Hg, respectively). The systolic volume (52.6 ± 11.9 and 60 ± 12.4 mL) and the cardiac output (4.3 ± 0.5 and 4.6 ± 0.5 L/min) decreased in the DM1 group in relation to the control group. The pulse pressure amplification (PPA) was significantly lower in the DM1 group (1.4 ± 0.15) compared with the control group (1.6 ± 0.17). PPA correlated negatively with total vascular resistance (TVR), AP and reflection coefficient, and positively with cardiac index in both groups. In the DMI group, the AIx@75 correlated negatively with age, height, systolic volume, and PPA, and correlated positively with the TVR and reflection coefficient.
These results confirm the presence of arterial stiffness in this population and extend the knowledge, showing, for the first time, the reduction of PPA in the DM1 group.
背景/目的：1 型糖尿病（DM1）存在发生心血管事件的重要危险因素。
比较 DM1 患儿与健康儿童的主动脉脉搏波（APW）成分和血流动力学参数。
这是一项横断面研究，共纳入 36 名 DM1 患儿（11.9±3.2 岁）和 36 名匹配性别和年龄的健康对照组儿童（12.4±2.9 岁）。使用 Mobil-O-Graph 无创性评估 APW 成分和血流动力学参数。
在评估周，DM1 患儿的糖化血红蛋白（HbA1c）为 9.48±2.22%，空腹血糖为 222.58±93.22mg/dL。与对照组（20.6±7.9%、53.4±9.1 和 4.9±2.1mmHg）相比，DM1 组的增强指数（AIx@75）、反射系数和增强压（AP）显著更高（分别为 29.0±9.7%、63.0±7.9%和 7.8±2.7mmHg）。与对照组相比，DM1 组的收缩量（52.6±11.9 和 60±12.4mL）和心输出量（4.3±0.5 和 4.6±0.5L/min）降低。DM1 组的脉搏压放大率（PPA）（1.4±0.15）显著低于对照组（1.6±0.17）。在两组中，PPA 与总血管阻力（TVR）、AP 和反射系数呈负相关，与心指数呈正相关。在 DM1 组，AIx@75 与年龄、身高、收缩量和 PPA 呈负相关，与 TVR 和反射系数呈正相关。
这些结果证实了该人群存在动脉僵硬度，并扩展了相关知识，首次显示 DM1 组 PPA 降低。
