Harnois-Leblanc Soren, McNealis Vanessa, Friedrich Matthias G, Bigras Jean-Luc, Van Hulst Andraea, Nuyt Anne Monique, Barnett Tracie A, Benedetti Andrea, Mathieu Marie-Ève, Drapeau Vicky, Sylvestre Marie-Pierre, Henderson Mélanie
Research Center of the Sainte-Justine University Hospital, Montréal, QC, Canada.
Department of Preventive and Social Medicine, School of Public Health, Université de Montréal, Montréal, QC, Canada.
Pediatr Diabetes. 2023 Aug 24;2023:8662038. doi: 10.1155/2023/8662038. eCollection 2023.
Despite heightened risk of cardiovascular disease (CVD) among individuals with type 1 diabetes, few studies in this population have investigated the development of CVD using early markers in adolescence. We compared risk factors (blood pressure (BP) and dyslipidemia) and early markers of CVD between adolescents with and without type 1 diabetes and explored effect modification by sex.
Cross-sectional study using data from the CARdiovascular Disease risk in pEdiatric type 1 diAbetes (CARDEA) study. We recruited 100 adolescents with type 1 diabetes at the Sainte-Justine University Hospital Center and 97 adolescents without diabetes (14-18 years). We measured arterial stiffness by carotid-femoral pulse wave velocity, endothelial function by brachial artery flow-mediated dilation test, as well as left ventricular (LV) mass, papillary mass, and wall thickness by cardiac MRI. We used multivariable linear regression models to assess the impact of type 1 diabetes on each outcome adjusting for age, sex, ethnicity, adiposity, and familial income.
Adolescents with type 1 diabetes had 0.21 standard deviations (SD) (95% CI: 0.04; 0.38) higher diastolic blood pressure -score (zDBP), 0.21 mmol/L (95% CI: 0.02; 0.40) higher low-density lipoprotein cholesterol (LDL-c) levels, and 17% (95% CI: 4; 29) higher triglyceride levels and lower endothelial function based on acceleration (-77.4 cm/s, 95% CI: -133.1; -21.6) compared with adolescents without diabetes. Girls with type 1 diabetes had higher systolic blood pressure -score (zSBP), and boys with type 1 diabetes had lower LV mass and wall thickness compared to healthy peers.
In addition to higher BP and abnormal lipid profiles, adolescents with type 1 diabetes present endothelial dysfunction and alterations in cardiac structure (in boys) compared to adolescents without diabetes, suggesting that CVD prevention should be incorporated into type 1 diabetes management early in the disease.
尽管1型糖尿病患者患心血管疾病（CVD）的风险增加，但针对该人群的研究中，很少有研究使用青少年时期的早期标志物来调查CVD的发展情况。我们比较了患有和未患有1型糖尿病的青少年之间的风险因素（血压（BP）和血脂异常）以及CVD的早期标志物，并探讨了性别对其的影响。
采用来自儿童1型糖尿病心血管疾病风险（CARDEA）研究的数据进行横断面研究。我们在圣朱斯汀大学医院中心招募了100名患有1型糖尿病的青少年和97名无糖尿病的青少年（14 - 18岁）。我们通过颈股脉搏波速度测量动脉僵硬度，通过肱动脉血流介导的扩张试验测量内皮功能，并通过心脏磁共振成像测量左心室（LV）质量、乳头肌质量和壁厚。我们使用多变量线性回归模型来评估1型糖尿病对每个结局的影响，并对年龄、性别、种族、肥胖和家庭收入进行了调整。
与无糖尿病的青少年相比，患有1型糖尿病的青少年舒张压评分（zDBP）高0.21个标准差（SD）（95%CI：0.04；0.38），低密度脂蛋白胆固醇（LDL-c）水平高0.21 mmol/L（95%CI：0.02；0.40），甘油三酯水平高17%（95%CI：4；29），且基于加速度的内皮功能更低（-77.4 cm/s，95%CI：-133.1；-21.6）。与健康同龄人相比，患有1型糖尿病的女孩收缩压评分（zSBP）更高，患有1型糖尿病的男孩左心室质量和壁厚更低。
与无糖尿病的青少年相比，患有1型糖尿病的青少年除了血压更高和血脂异常外，还存在内皮功能障碍和心脏结构改变（男孩），这表明应在疾病早期将CVD预防纳入1型糖尿病管理中。
