Division of Endocrinology and Diabetes, Phoenix Children's Hospital, Phoenix, Arizona.
Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona.
Pediatr Diabetes. 2019 Nov;20(7):941-945. doi: 10.1111/pedi.12893. Epub 2019 Jul 21.
Epicardial adipose thickness (EAT) is increased in adults with type 1 diabetes (T1D) and is thought to contribute to cardiovascular disease (CVD) in this population. Given that CVD risk factors emerge early in life, the purpose of this study was to identify whether EAT is increased in pediatric patients with T1D compared with non-diabetic controls.
Anthropometric data, blood pressure (BP), and EAT were evaluated in 20 youth with T1D and 20 age, sex, and body mass index (BMI) matched healthy controls between the ages of 5 and 18 years.
EAT was 18.5% higher among youth with T1D compared to healthy controls (1.65 ± 0.44 mm vs 1.37 ± 0.27 mm, P = .02). In the entire cohort, EAT was correlated with age (r = 0.71, P < .001), BMI (r = .69, P < .001), waist circumference (r = 0.60, P < .001), systolic BP (r = .34, P = .03), and diastolic BP (r = 0.41, P = .009). Among youth with T1D, there were no significant correlations between EAT and HbA1c (r = -0.16, P = .50), insulin dose (r = .09, P = .71), or duration of disease (r = 0.06, P = .82).
Youth with T1D exhibited significantly higher EAT compared to controls. Increased EAT was associated with adiposity and BP, but not duration of disease, insulin dose, or glycemic control. Increased EAT may represent a pathophysiologic mechanism leading to premature CVD in pediatric patients with T1D.
在 1 型糖尿病(T1D)患者中,心外膜脂肪厚度(EAT)增加,并且认为这会导致该人群的心血管疾病(CVD)。鉴于 CVD 危险因素在生命早期出现,本研究的目的是确定与非糖尿病对照相比,T1D 儿科患者的 EAT 是否增加。
在 5 至 18 岁的 20 名 T1D 青年和 20 名年龄、性别和体重指数(BMI)匹配的健康对照中评估了人体测量数据、血压(BP)和 EAT。
与健康对照组相比,T1D 青少年的 EAT 高 18.5%(1.65±0.44mm 比 1.37±0.27mm,P=0.02)。在整个队列中,EAT 与年龄(r=0.71,P<0.001)、BMI(r=0.69,P<0.001)、腰围(r=0.60,P<0.001)、收缩压(r=0.34,P=0.03)和舒张压(r=0.41,P=0.009)相关。在 T1D 青少年中,EAT 与 HbA1c(r=-0.16,P=0.50)、胰岛素剂量(r=0.09,P=0.71)或疾病持续时间(r=0.06,P=0.82)之间无显著相关性。
与对照组相比,T1D 青少年的 EAT 明显更高。增加的 EAT 与肥胖和 BP 相关,但与疾病持续时间、胰岛素剂量或血糖控制无关。EAT 的增加可能代表导致 T1D 儿科患者过早发生 CVD 的病理生理机制。