Cardiovascular risk in pediatric type 1 diabetes: sex-specific intima-media thickening verified by automatic contour identification and analyzing systems

Abstract

On the basis of sex differences of cRFs and cIMT in pediatric T1D, the assessment of sex-specific IMT percentiles facilitates a differentiated interpretation of subclinical atherosclerosis. The underlying diabetes and additional cRFs seem to be more important determinants of intima-media thickening than age. To improve the comparability of IMT measurements of relevant studies, the international harmonization of IMT measurements should be aimed for.

Decreased levels of homoarginine and asymmetric dimethylarginine in children with type 1 diabetes: associations with cardiovascular risk factors but no effect by atorvastin

“…An association between intimamedia thickness or extramedial thickness of common carotid arteries and homoarginine could not be found (22). In general, children with T1D however are at high risk of premature, subclinical atherosclerosis which has been confirmed by providing evidence of endothelial dysfunction and increased intimamedia thickness (7,23). One particularly interesting aspect of our study is the inverse correlation between HoArg and HbA1c in children with T1D which leads to the thought that there are close links between HoArg and glucose metabolism.…”

“…There were six dropouts due to one fatal traffic accident and five cases of noncompliance because of poor glycemic control with HbA1c > 9.5% measured twice within a period of 4 weeks, inadequate intake of the study medication, or failure to attend the study visits. For ethical reasons and to avoid unnecessary use of atorvastatin therapy, only diabetic children with carotid intima-media thickness values (A. Schmidt-Trucksäss) above the 75th percentile were included (7). T1D was diagnosed according to the American Diabetes Association (16).…”

“…Because HoArg shows structural similarity to L-arginine, it can serve as a substrate or act as an inhibitor for nitric oxide (NO) synthesis thus increasing or decreasing NO production in the endothelium (3,4). In adults with cardiovascular disease or type 2 diabetes, low HoArg has been shown to be associated with cardiovascular morbidity (5,6) In children and adolescents with type 1 diabetes (T1D) who are known to be at risk for developing premature atherosclerosis (7,8), data on HoArg plasma concentrations are not available in the literature. Asymmetric dimethylarginine (ADMA) is an endogenous form of the amino acid arginine and exhibits potent inhibitory activities on endothelial nitric oxide synthases (eNOS) (9).…”

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…[93][94][95][96][97] Factors associated with this higher cIMT include lower vitamin C levels 98 and longer duration of disease. 99,100 Adolescents with T2DM also demonstrate higher cIMT compared with healthy control subjects, 101,102 with diabetes mellitus duration 103 and glucose control playing a role. 104 Factors affecting the progression of cIMT in adolescents and young adults with diabetes mellitus include the number of receptors for advanced glycation end products, 105 HbA 1c , 106 and diabetes mellitus duration.…”

Cardiovascular Risk in Children and Adolescents with Type 1 and Type 2 Diabetes Mellitus

“…In a study of 270 German children with T1DM, boys had significantly higher bilateral mean CIMT compared to females, and the authors developed sex-specific CIMT percentiles. CIMT was related to diabetes duration and pulse pressure in males, and with LDL-C, HbA1c, and diabetes duration in females 114 . However, longitudinal studies of CIMT in youth with diabetes are very limited.…”