Association between Vascular Endothelial Markers and Carotid Intima-Media Thickness in Children and Adolescents with Type 1 Diabetes Mellitus

Rostampour, Noushin; Fekri, Kiavash; Hashemi-Dehkordi, Elham; Obodiat, Mahdieh

doi:10.7860/jcdr/2017/26623.10541

Cited by 16 publications

(14 citation statements)

References 32 publications

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“…These report saturated fat intakes above recommendations and inadequate serves of fruit and vegetables 7 9. This is concerning as children and adolescents with T1D have a greater risk of overweight or obesity, dyslipidemia, atherosclerosis and cardiovascular disease 7 8 10 18–21. Specific strategies and interventions to promote dietary quality and particularly vegetable intake in children are required.…”

Section: Discussionmentioning

confidence: 99%

Dietary intake and eating patterns of young children with type 1 diabetes achieving glycemic targets

Seckold¹,

Howley

King³

et al. 2019

BMJ Open Diab Res Care

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IntroductionYoung children with type 1 diabetes (T1D) consume more saturated fat and less fruit and vegetables than recommended. A common challenge in this age group is unpredictable appetite potentially impacting the way parents manage diabetes cares at mealtimes. This small study aimed to assess nutritional intake and mealtime routines of young children with T1D in a clinic where the majority of children were achieving glycemic targets. A secondary aim was to explore association of eating pattern with HbA1c.MethodsA retrospective, cross-sectional review of children aged less than 7.0 years with T1D attending a pediatric diabetes service in Australia was performed (n=24). Baseline characteristics, glycated hemoglobin (HbA1c), a 3-day weighed food diary and a mealtime management survey were collected.ResultsTwenty-two children (55% male) were included aged 4.9±1.3 years (mean±SD), HbA1c 47±10 mmol/mol (6.4%±0.9%), body mass index Z-score 0.8±0.9 and diabetes duration 1.7±1.1 years. Preprandial insulin use was reported in 95% of children. Macronutrient distribution (% energy intake) was carbohydrate (48%±4%), protein (16%±2%) and fat (33%±5%) with saturated fat (15%±3%). The majority of children did not meet vegetable and lean meat/protein intake recommendations (0% and 28%, respectively). HbA1c was not correlated with daily total carbohydrate, protein or fat intake (p>0.05). HbA1c was significantly higher in children offered food in a grazing pattern compared with those offered regular meals (mean 61 mmol/mol vs 43 mmol/mol (7.7% vs 6.1%), p=0.01).ConclusionsDietary quality is a concern in young children with T1D with excessive saturated fat and inadequate vegetable intake. Our results suggest that young children meeting glycemic targets give insulin before meals and follow a routine eating pattern.

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Section: Discussionmentioning

confidence: 99%

Dietary intake and eating patterns of young children with type 1 diabetes achieving glycemic targets

Seckold¹,

Howley

King³

et al. 2019

BMJ Open Diab Res Care

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“…Increased CIMT was found in children with type 1 diabetes mellitus, familial hypercholesterolemia, hypertension, and metabolic syndrome. 2,4,7,25,26 Children after therapy of ALL are also at substantial risk of cardiovascular disease development in adulthood. 15,16,27 It was also confirmed that cancer childhood survivors are approx.…”

Section: Discussionmentioning

confidence: 99%

“…1 Increased CIMT was found in children with metabolic syndrome, congenital adrenal hyperplasia, obesity, type 1 diabetes mellitus, and also in childhood cancer survivors. [2][3][4][5][6][7] However, the lack of pediatric, population-based reference values makes CIMT not a widely accepted marker of subclinical atherosclerosis in youth with cardiovascular risk factors. 8 The developing cardiovascular system in children is highly susceptible to the toxic effects of chemotherapeutic agents and their administration may cause endothelial damage leading to endothelial dysfunction.…”

Section: Introductionmentioning

confidence: 99%

CIMT does not identify early vascular changes in childhood acute lymphoblastic leukemia survivors

Ociepa¹,

Posio²,

Sawicki³

et al. 2020

Adv Clin Exp Med

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Background. Childhood acute lymphoblastic leukemia (ALL) survivors are at an increased risk of cardiovascular disease development. It is believed that in the general population, this risk can be predicted with carotid intima-media thickness (CIMT) measurement. Objectives. The objective of this study was to assess CIMT and to investigate the effects of blood pressure (BP) and lipid profile values on CIMT in childhood ALL survivors. Material and methods. The study group comprised 81 childhood ALL survivors aged 5-25 years. The control group consisted of 52 age-and sex-comparable healthy children. Carotid intima-media thickness measurement, 24-hour BP monitoring and lipid profiles were evaluated in patients and controls. Results. Despite significantly higher proportion of subjects with arterial hypertension (AH) (30/81 vs 10/52; p = 0.0315), the mean values of CIMT were not statistically different in childhood ALL survivors as compared to controls (0.4303 ±0.03 vs 0.4291 ±0.03; p = 0.81 and 1.096 ±0.74 vs 1.027 ±0.55; p = 0.56, respectively). Carotid intima-media thickness values were not statistically higher in ALL survivors with AH as compared to ALL survivors with normal BP (0.433 ±0.03 vs 0.428 ±0.03; p = 0.82). A significant positive correlation between 24-hour systolic BP standard deviation score (SDS) and CIMT-SDS in childhood ALL survivors was found (r = 0.29, p = 0.009), whereas such correlation was not observed in healthy controls (r = 0. 12, p = 0.39). A significant correlation between z-score body mass index (BMI) and CIMT was found in controls (r = 0.29, p = 0.031) but not in childhood ALL survivors (r = −0.05, p = 0.64). No significant correlations between CIMT and other measured variables were found. Carotid intima-media thickness did not significantly correlate with time since ALL diagnosis (r = 0.09, p = 0.39). Conclusions. Carotid intima-media thickness measurement shows limited feasibility and diagnostic accuracy for early assessment of vascular alteration in childhood ALL survivors. Other tests are needed to predict cardiovascular risk in childhood ALL survivors at the early stage of the follow-up.

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“…Since atherosclerosis in children with FH typically presents in subclinical stage, standard diagnostic imaging methods might not be su cient. Even discreet morphological changes (thickening of intimamedia complex [IMC] evaluated with ultrasound [6,7]), may be absent while the function of the arterial wall is impaired already. This stiffening process can be assessed with applanation tonometry, with the pulse wave velocity (PWV) and augmentation index (AI) being its two common surrogates.…”

Section: Introductionmentioning

confidence: 99%

“Apple does not fall far from the tree” – subclinical atherosclerosis in children with familial hypercholesterolemia.

Podgórski

Szatko

Stańczyk

et al. 2020

Preprint

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Background: Familial hypercholesterolemia (FH) increases the risk of atherosclerosis in children and adults. Atherosclerotic cardiovascular disease in young patients FH is usually subclinical but recognition of children with more pronounced changes is crucial for adjusting effective management. Aim of this research was to use ultrasonography with two-dimensional speckle tracking (2DST) and tonometry to evaluate atherosclerotic changes in patients with FH (parents and their offspring).Methods: Applanation tonometry and carotid arteries sonography with evaluation of the intima-media complex thickness (IMCT) and application of the 2DST were performed in 20 families with FH (20 parents and 29 children). The same size control group (age and sex matched) was included. Results were compared between peers and between generations together with the correlation analysis.Results: Adults with FH, in comparison with healthy peers, presented significantly more atherosclerotic plaques (9 vs. 2, p=0.0230), had significantly thicker IMC (0.84±0.19 vs. 0.56±0.06 mm, p<0.0001) and had stiffer arterial wall (for stain: 6.25±2.3 vs. 8.15±2.46, p=0.0103). In children from both groups there were no atherosclerotic plaques and IMCT did not differ significantly (0.42±0.07 vs. 0.39±0.04, p=0.1722). However, children with FH had significantly stiffer arterial wall according to 2DST (for strain: 9.22±3.4 vs. 11.93±3.11, p=0.0057) and tonometry (for the pulse wave velocity: 4.5±0.64 vs.3.96±0.62, p=0.0047). These parameters correlated with atherosclerosis surrogates in their parents (p<0.001) but were not significantly affected by presence of presumed pathogenic gene variant.Conclusions: Children with FH presented subclinical atherosclerosis manifested as decreased arterial wall elasticity. Degree of stiffening was associated with advancement of atherosclerosis in their parents but did not present significant association with gene variants. Sonography with application of 2DST seems to be a good candidate for comprehensive evaluation of atherosclerosis in families with FH.

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Association between Vascular Endothelial Markers and Carotid Intima-Media Thickness in Children and Adolescents with Type 1 Diabetes Mellitus

Cited by 16 publications

References 32 publications

Dietary intake and eating patterns of young children with type 1 diabetes achieving glycemic targets

Dietary intake and eating patterns of young children with type 1 diabetes achieving glycemic targets

CIMT does not identify early vascular changes in childhood acute lymphoblastic leukemia survivors

“Apple does not fall far from the tree” – subclinical atherosclerosis in children with familial hypercholesterolemia.

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