Association between markers of endothelial dysfunction and early signs of renal dysfunction in pediatric obesity and type 1 diabetes

Abstract

Obese children have increased markers of endothelial dysfunction and early signs of renal damage, similarly to children with T1D, confirming obesity to be a cardiovascular risk factor as T1D. The association between ICAM-1 with e-GFR and AER confirm the known the association between general endothelial and renal dysfunction.

ISPAD Clinical Practice Consensus Guidelines 2018: Microvascular and macrovascular complications in children and adolescents

“…Family history of vascular complications or cardiovascular risk factors increases the risk for nephropathy. 29,30 Higher body mass index (BMI) is a risk factor for microalbuminuria, 31 retinopathy 32 , neuropathy, 33 and CVD. 34 Lifestyle issues also contribute to complications risk; sedentary men with diabetes have higher mortality than active individuals.…”

“…Family history of vascular complications or cardiovascular risk factors increases the risk for nephropathy . Higher body mass index (BMI) is a risk factor for microalbuminuria, retinopathy, neuropathy, and CVD …”

Oxidative stress in chronic kidney disease

“…In addition, intercellular adhesion molecule-1 (ICAM-1) was significantly increased in obese children and correlated with markers of renal function such as eGFR. Therefore, endothelial dysfunction might be an early step in both cardiovascular disease and renal dysfunction in young people [106].…”

Research update for articles published in EJCI in 2016

“…Myeloperoxidase was not significantly associated with renal function in a study involving older children with obesity or type 1 diabetes and healthy controls. 16 However, this analysis was not performed separately for obese children and glomerular filtration rate (GFR) was calculated using a different formula (Bouvet formula) 16 from that used in our study (Zappitelli combined formula). 13 The Bouvet formula, but not the Zappitelli combined formula, appears to yield an underestimation of GFR values in comparison with the reference standard for GFR (inulin clearance) and is limited by the use of creatinine values assessed by the Jaffe method.…”

“…Myeloperoxidase association with GFR was not observed in a study involving older children with obesity and type 1 diabetes. 16 However, this was not analysed separately for obese children and GFR was calculated with Bouvet formula, 16 which is limited by the use of Jaffe method assessed creatinine and appears to underestimate GFR values. Women presenting with acute myocardial infarction (AMI) are still managed in a much less aggressive and invasive way than men.…”