Preclinical Morphofunctional Alterations of Large Arteries in Children and Adolescent with Type 1 Diabetes Mellitus: Preliminary Data

Background: Children and adolescent with type 1 diabetes mellitus(T1DM) are considered one of the pediatric populations at highest cardiovascularrisk.Aim: This cross-sectional study was aimed to assess in children andadolescents with T1DM, the clinical correlates of early morphofunctionalchanges of the large arteries.Methods: Children and adolescents with T1DM treated with basal-bolusinsulin therapy were included in the study if they had a disease duration ofat least 5 years. The following parameter were examined: waist circumference,waist/height ratio (W/H), BMI, blood pressures, lipid profile, microalbuminuria,insulin dose, HbA1c, carotid intima-media thickness (c-IMT) andthe difference between the observed and 95th percentile of age and heightc-IMT distribution (Δc-IMT), aortic pulse wave velocity (Ao PWV) and thedifference between the observed and 90th percentile of age Ao PWV distribution(ΔPWVAo). The study population was divided into two groups, on thebasis of a value of W/H < or > 0.5.Results: A total of 45 (20 males and 25 females) children and adolescentswere included in the study. Their mean age was 14.0±2.7 years, their diseaseduration 6.2±3.5 years. Significant correlations were found betweenW/H and age Δc-IMT (p= 0.009), height Δc-IMT (p= 0.008), and mean c-IMT(p= 0.015). AoPWV correlated with HbA1c values (p= 0.012), diastolic bloodpressures (p=0.014), triglycerides (TG) (p= 0.009) and with microalbuminuria(p= 0.017). Subjects with W/H > 0.5 have higher values of mean c-IMT(p= 0.03), age ∆cIMT (p=0.02) and height ∆cIMT (p= 0.02).Conclusion: In children and adolescents with T1DM morphofunctionalchanges of the large arteries are associated with different clinical features,including the waist/height ratio. It showed a stronger correlation withc-IMTA than other indices of adiposity. Its simple measurement may allow tobetter assess the cardiovascular risk of T1DM pediatric patients.