Relation between carotid intima media thickness and oxidative stress markers in type 1 diabetic children and adolescents

Abstract

BackgroundCarotid intima media thickness (CIMT) is a non invasive marker of subclinical atherosclerosis. Hyperglycemia, oxidatively modified atherogenic lipoproteins and advanced glycation end products are linked to increased oxidative stress in diabetes. We aimed to find out the relation between carotid intima media thickness in type 1 diabetic children and adolescents and plasma nitric oxide and total antioxidant capacity levels as markers of oxidative stress.MethodsThis study included 50 children and adolescents with type 1 diabetes mellitus with mean age (9.7 ± 3.4 years) and 50 healthy age and sex matched controls. They were subjected to assessment of hemoglobin A1c, total cholesterol and triglycerides, serum total antioxidant capacity, serum nitric oxide (NO) by colorimetric method and carotid intima media thickness by B-mode ultrasound.ResultsThere was significant elevation in serum nitric oxide (17.07 ± 6.4 vs 12.6 ± 4.7 μmol/L; p < 0.001), CIMT (0.47 ± 0.04 vs 0.39 ± 0.02 mm; p < 0.001) and significant reduction in serum total antioxidant capacity (0.41 ± 0.29 vs 0.87 ± 0.23 mmol/L; p < 0.001) in diabetic patients compared to controls. Carotid intima media thickness was correlated positively with nitric oxide (r = 0.402, p = 0.01) and negatively with total antioxidant capacity (r = -0.341, p = 0.02). Carotid intima media thickness was also correlated positively with age, duration of diabetes but not correlated with glycemic control or lipid profile.ConclusionThe significant elevation in nitric oxide and reduction in total antioxidant capacity in children and adolescents with type 1 diabetes mellitus with their correlation with carotid intima media thickness may reflect the role of oxidative stress in the development of atherosclerosis in young type 1 diabetic subjects.

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

“…In these studies, the duration of the disease was shorter than that in our study, which might explain our findings. Furthermore, we found no association between CIMT and glycemic control measured by HbA1c, as reported in other studies (19,20). Our results are similar to those of another study in a cohort of 603 patients with type 1 DM followed up for 10 years, which found that a better glycemic control was unable to predict the occurrence of coronary artery disease (CAD), in contrast to insulin resistance measured by eGDR, which emerged as a predictor of CAD endpoints (27).…”

“…A study in 150 patients with longstanding type 1 DM has found a lower prevalence of subclinical atherosclerosis (18). In contrast, other studies have reported increased CIMT in children and adolescents with type 1 DM, demonstrating that the atherosclerotic process may start at a young age in these patients (19,20). Our results provide further evidence of the importance of screening for subclinical CVD in women with type 1 DM.…”

“…This finding contrasts with previous studies that have demonstrated that CIMT increases with the duration of type 1 DM (19,20,36). In these studies, the duration of the disease was shorter than that in our study, which might explain our findings.…”

“…There are controversies in the literature regarding the association of age and CIMT, in which positive (20,36) and negative (19) results have been reported, but none of these studies have evaluated the presence of carotid plaques.…”

Elevation of oxidative stress markers in Type 1 diabetic children

“…Our data revealed that the total antioxidant activity (ORAC) decreased in the plasma of children with diabetes in favor of an oxidative stress in such patients. These results are in agreement with previous studies (El Samahy et al, 2013;Varvarovská et al, 2003).…”