Putarek Kresimir, Banfic Ljiljana, Pasalic Marijan, Krnic Nevena, Spehar Uroic Anita, Rojnic Putarek Natasa
Department of Cardiovascular Diseases, Zagreb University Hospital Centre, Zagreb, Croatia.
Department of Cardiovascular Diseases, Zagreb University Hospital Centre, School of Medicine, Zagreb, Croatia.
J Pediatr Endocrinol Metab. 2018 Dec 19;31(12):1315-1323. doi: 10.1515/jpem-2018-0137.
Background Cardiovascular disease (CVD) is the end result of vascular aging and atherosclerosis, having its origins in childhood. The aim of our study was to compare arterial stiffness (AS) and intima-media thickness (IMT) as markers of an early vascular damage between obese adolescents, adolescents with diabetes type 1 (T1D) and lean control subjects. Methods We analyzed AS and IMT in 68 obese adolescents (13.27±2.31 years), 42 adolescents with T1D (14.95±2.35 years) lasting over 5 years and 38 controls (15.02±1.94 years). AS (measured by pulse wave velocity [PWV], arterial compliance [AC] and β-stiffness) and IMT were assessed using an e-tracking ultrasound method. Results A significant difference between the groups was found for AC (p=0.022) and PWV (p=0.010), with the lowest compliance and higher velocities in T1D patients. When corrected for age, the difference in AC among the groups did not reach a statistical difference (p=0.059). Correlation analysis in the obese adolescents showed lower AC in females (p=0.041), with higher systolic blood pressure (SBP) (p=0.032). In T1D adolescents, disease duration was the strongest determinant of AS (AC p=0.028, β p=0.029 and PWV p=0.003), followed by body mass index (BMI; PWV p=0.008; β p=0.033), SBP (AC p<0.001; PWV p=0.023), diastolic BP (AC p=0.049; PWV p=0.048) and HbA1c (PWV p=0.048). No significant correlations were found for AS measures or IMT with sex, age, BMI, Tanner stage or BP levels in controls. Conclusions Early vascular damage is more pronounced in T1D adolescents than in obese or lean adolescents, which may emphasize the impact of hyperglycemia as a major threat for cardiovascular health.
心血管疾病（CVD）是血管老化和动脉粥样硬化的最终结果，其起源于儿童时期。我们研究的目的是比较肥胖青少年、1型糖尿病（T1D）青少年和瘦的对照受试者之间的动脉僵硬度（AS）和内膜中层厚度（IMT），作为早期血管损伤的标志物。方法：我们分析了68名肥胖青少年（13.27±2.31岁）、42名病程超过5年的T1D青少年（14.95±2.35岁）和38名对照者（15.02±1.94岁）的AS和IMT。使用电子追踪超声方法评估AS（通过脉搏波速度[PWV]、动脉顺应性[AC]和β僵硬度测量）和IMT。结果：在AC（p = 0.022）和PWV（p = 0.010）方面发现组间存在显著差异，T1D患者的顺应性最低且速度更高。校正年龄后，组间AC差异未达到统计学差异（p = 0.059）。肥胖青少年的相关性分析显示，女性的AC较低（p = 0.041），收缩压（SBP）较高（p = 0.032）。在T1D青少年中，疾病持续时间是AS的最强决定因素（AC p = 0.028，β p = 0.029，PWV p = 0.003），其次是体重指数（BMI；PWV p = 0.008；β p = 0.033）、SBP（AC p<0.001；PWV p = 0.023）、舒张压（AC p = 0.049；PWV p = 0.048）和糖化血红蛋白（HbA1c；PWV p = 0.048）。在对照者中，未发现AS测量值或IMT与性别、年龄、BMI、坦纳分期或血压水平之间存在显著相关性。结论：早期血管损伤在T1D青少年中比在肥胖或瘦的青少年中更明显，这可能强调了高血糖作为心血管健康主要威胁的影响。
