Hs-CRP is associated with weight, BMI, and female sex but not with endothelial function in children with type 1 diabetes

Abstract

Background: Atherosclerosis is an inflammatory process, and high‐sensitivity C‐reactive protein (Hs‐CRP), a marker of inflammation, predicts cardiovascular events in adults. Vascular endothelial and smooth muscle dysfunction, measurable precursors of atherosclerosis, begin in childhood. Therefore, we sought to determine if Hs‐CRP is associated with vascular endothelial and smooth muscle dysfunction in children with type 1 diabetes mellitus (T1DM) and healthy control subjects. Methods: Hs‐CRP and endothelial function assessed by flow‐mediated dilatation (FMD) and smooth muscle function assessed by glyceryl‐trinitrate (GTN)‐induced dilatation were measured in 121 subjects with T1DM aged 14.1 (2.9) yr, of whom 31 were also studied at 4 and 8 wk, and in 33 healthy controls aged 14.2 (3.6) yr. Results: Hs‐CRP did not differ between subjects with T1DM and healthy, age‐matched controls. In both controls and subjects with T1DM, Hs‐CRP did not relate to FMD or GTN at baseline or at intervals over 8 wk in T1DM. Hs‐CRP did not change over time. In T1DM, but not healthy controls, Hs‐CRP related to body mass index (BMI) z‐score (r = 0.47, p < 0.001), weight z‐score (r = 0.41, p < 0.001), and female sex (p = 0.008). Conclusions: Hs‐CRP is not associated with early vascular dysfunction in children with T1DM. However, in children and adolescents with T1DM, Hs‐CRP was associated with female sex and children with higher BMI, suggesting that these groups may be at greater cardiovascular risk. Maintenance of a healthy BMI may be important in the prevention of vascular disease of T1DM.

Arterial stiffness is not increased in teens with early uncomplicated type 1 diabetes mellitus

“…In a previous study, however, the level of highly sensitive C-reactive protein, an inflammation marker, was not elevated in children with type 1 diabetes with a mean diabetes duration of 5.3 years [7].…”

“…However, studies comparing arterial stiffness in people with type 1 diabetes with that in nondiabetic controls have provided controversial results [3,6,7], possibly due to multiple factors. Duration of type 1 DM is one of the most important factors contributing to the development of vascular pathological changes [2].…”

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…Poor endothelial function was associated with higher HbA 1c 121 and poor fitness level 122 but was not related to inflammation. 123 Endothelial dysfunction has also been found in youth with T2DM when measured by flow-mediated dilation 101 venous plethysmography. 124 Interventions including exercise 125 and intensive glucose control 126 improved endothelial function in young patients with T1DM.…”

Urinary matrix metalloproteinase activities: biomarkers for plaque angiogenesis and nephropathy in diabetes

“…Controlling hyperglycemia and dyslipidemia are important for diabetes management; however, HbA1c and lipid profiles do not sufficiently stratify risk for renal and vascular complications (1,14). Furthermore, C-reactive protein has reduced prognostic significance in diabetes (19,21). Thus new biomarkers for cardiovascular and renal complications would be clinically useful tools in diabetes care.…”