Microvascular autoregulation in children and adolescents with type 1 diabetes mellitus

Schlager, Oliver; Hammer, Alexandra; Willfort-Ehringer, Andrea; Fritsch, Maria; Rami-Merhar, Birgit; Schober, Edith; Nagl, Katrin; Giurgea, Aura; Margeta, Christian; Zehetmayer, Sonja; Schernthaner, Gerit‐Holger; Koppensteiner, Renate; Gschwandtner, Michael E.

doi:10.1007/s00125-012-2502-8

Cited by 17 publications

(23 citation statements)

References 48 publications

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“…Several other authors have found the same results in T1D and T2D31, whereas others have found no difference between diabetics and control subjects1532 and, in one study, a surprising increase in PORH response33. The lack of difference between diabetics and control subjects could be due to a higher age of the population studied32 or a higher duration of diabetes15 that may have minimized the difference between the populations.…”

Section: Discussionmentioning

confidence: 75%

Neurovascular microcirculatory vasodilation mediated by C-fibers and Transient receptor potential vanilloid-type-1 channels (TRPV 1) is impaired in type 1 diabetes

Marche

Dubois

Ábrahám

et al. 2017

Sci Rep

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Microvascular dysfunction may have an early onset in type 1 diabetes (T1D) and can precede major complications. Our objectives were to assess the endothelial-dependent (acetylcholine, ACh; and post-occlusive hyperemia, PORH), non-endothelial-dependent (sodium nitroprusside, SNP) and neurovascular-dependent (local heating, LH and current induced vasodilation, CIV) microcirculatory vasodilation in T1D patients compared with matched control subjects using a laser speckle contrast imager. Seventeen T1D patients - matched with 17 subjects according to age, gender, Body-Mass-Index, and smoking status - underwent macro- and microvascular investigations. The LH early peak assessed the transient receptor potential vanilloid type 1 channels (TRPV1) mediated vasodilation, whereas the plateau assessed the Nitirc-Oxyde (NO) and endothelium-derived hyperpolarizing factor (EDHF) pathways. PORH explored sensory nerves and (EDHF), while CIV assessed sensory nerves (C-fibers) and prostaglandin-mediated vasodilation. Using neurological investigations, we observed that C-fiber and A-delta fiber functions in T1D patients were similar to control subjects. PORH, CIV, LH peak and plateau vasodilations were significantly decreased in T1D patients compared to controls, whereas there was no difference between the two groups for ACh and SNP vasodilations. Neurovascular microcirculatory vasodilations (C-fibers and TRPV 1-mediated vasodilations) are impaired in TD1 patients whereas no abnormalities were found using clinical neurological investigations. Clinicaltrials: No. NCT02538120.

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Section: Discussionmentioning

confidence: 75%

Neurovascular microcirculatory vasodilation mediated by C-fibers and Transient receptor potential vanilloid-type-1 channels (TRPV 1) is impaired in type 1 diabetes

Marche

Dubois

Ábrahám

et al. 2017

Sci Rep

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“…We have recently been able to demonstrate that aberrations of microvascular autoregulation already exist in children and adolescents with T1DM (48) after a rather short duration of diabetes. Thus, macro- and microvascular complications might already have their onset in the early “diabetes career.” Therefore, the resolution of diabetes as best as possible might be the most necessary strategy for preventing individual suffering.…”

Section: Discussionmentioning

confidence: 99%

Endothelial Progenitor Cells Are Related to Glycemic Control in Children With Type 1 Diabetes Over Time

et al. 2013

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OBJECTIVEThe risk of cardiovascular death before the age of 40 is 20-fold higher in patients with type 1 diabetes mellitus (T1DM). Endothelial progenitor cells (EPCs) predict cardiovascular morbidity and mortality in patients without diabetes. We hypothesized that EPCs are modified in children with T1DM and are related to characteristics of T1DM such as glycemic control.RESEARCH DESIGN AND METHODSChildren (n = 190; 156 T1DM subjects and 34 control subjects) were included in an observational cohort study and matched for age and sex. EPCs were enumerated by flow cytometry at the beginning (cross-sectional) and 1 year later (longitudinal). To analyze changes of variables during the observation, Δ values were calculated.RESULTSEPCs were significantly reduced in T1DM children versus control subjects (609 ± 359 vs. 1,165 ± 484, P < 0.001). Multivariate regression modeling revealed that glycated hemoglobin A1c (HbA1c) was the strongest independent predictor of EPCs (β = −0.355, P < 0.001). Overall glycemic control at the beginning and end of study did not differ (7.8 ± 1.2 vs. 7.8 ± 1.2 relative %, P = NS), but we observed individual HbA1c changes of −4.30/+3.10 relative %. The strongest EPC increase was observed in the patients with the most favorable HbA1c lowering during the 1-year follow-up. Accordingly, the strongest EPC decrease was demonstrated in the patients with the strongest HbA1c worsening during the time period.CONCLUSIONSThis is the first prospective study demonstrating diminished EPCs in children with T1DM. The association of better glycemic control with an increase in EPC numbers within 1 year suggests that a reduction of the high cardiovascular disease burden might be mediated likewise.

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“…The method of PORH has been described previously. 8,12,13 In brief, patients had to rest in a supine position for an accommodation period of 20 min. Following this resting period, baseline skin perfusion was recorded for 3 min (baseline perfusion, given in AU).…”

Section: Porhmentioning

confidence: 99%

“…6 Diabetes-induced microvascular dysfunction can be detected by post-occlusive reactive hyperaemia (PORH) using laser Doppler fluxmetry. 8 Laser Doppler fluxmetry non-invasively records the blood flow within the terminal Microvascular function in women with former gestational diabetes: A cohort study microvascular network of the papillary dermis. 9,10 Microvascular blood flow is adjusted by the tone of precapillary arterioles, which prevent the terminal network from hyperperfusion.…”

Section: Introductionmentioning

confidence: 99%

“…11 PORH as measured by laser Doppler fluxmetry potentially reveals subclinical microangiopathy upon metabolic disorders, such as diabetes. 8,[11][12][13][14] Focusing on GDM, previous research has shown that women with pGDM face an increased risk of macrovascular problems. 15,16 In contrast to GDM-induced macrovascular complications, data on the impact of GDM on microcirculation are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

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Microvascular function in women with former gestational diabetes: A cohort study

Charwat-Resl

Yarragudi

Heimbach

et al. 2017

Diabetes and Vascular Disease Research

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Objective: In the long term, diabetes mellitus is potentially associated with the occurrence of microvascular damage. This study sought to assess whether a history of prior gestational diabetes mellitus is associated with long-term effects on the women's microcirculation. Methods: Within the scope of a long-term follow-up of the 'Viennese Post-Gestational Diabetes Project', women with prior gestational diabetes mellitus as well as women with previous pregnancy but with no history of gestational diabetes mellitus (controls) were enrolled in this cross-sectional study. Microvascular function was assessed by post-occlusive reactive hyperaemia using laser Doppler fluxmetry. Baseline perfusion, biological zero, peak perfusion, time to peak and recovery time were recorded and compared between both groups. Results: Microvascular function was assessed in 55 women with prior gestational diabetes mellitus (46.1 ± 4.6 years) and 32 women with previous pregnancy but without prior gestational diabetes mellitus (42.9 ± 5.3 years). The mean period of time between delivery and the assessment of microvascular function was 16.2 ± 5.2 years in women with prior gestational diabetes mellitus group and 14.2 ± 4.8 years in controls. Regarding microvascular function, baseline perfusion, biological zero, peak perfusion, time to peak and recovery time did not differ between women with prior gestational diabetes mellitus and controls (all p > 0.05). Conclusion:In the long term, microvascular function appears not to be impaired in women with prior gestational diabetes mellitus.

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Microvascular autoregulation in children and adolescents with type 1 diabetes mellitus

Cited by 17 publications

References 48 publications

Neurovascular microcirculatory vasodilation mediated by C-fibers and Transient receptor potential vanilloid-type-1 channels (TRPV 1) is impaired in type 1 diabetes

Neurovascular microcirculatory vasodilation mediated by C-fibers and Transient receptor potential vanilloid-type-1 channels (TRPV 1) is impaired in type 1 diabetes

Endothelial Progenitor Cells Are Related to Glycemic Control in Children With Type 1 Diabetes Over Time

Microvascular function in women with former gestational diabetes: A cohort study

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