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Subclinical atherosclerosis in diabetic children: results of a longitudinal study

Robert Dalla Pozza1, Heinrich Netz, Hans-Peter Schwarz

  • 1Department of Pediatric Cardiology, University Children's Hospital, Ludwig-Maximilians-University, Munich, Germany. Robert.DallaPozza@med.uni-muenchen.de

Pediatric Diabetes
|June 12, 2009
PubMed

Insights

Subclinical atherosclerosis progression in diabetic children was monitored over two years. Higher hemoglobin A1c and systolic blood pressure correlated with increased intima-media thickness, suggesting risk factor control is vital.

Area of Science:

  • Pediatrics
  • Cardiology
  • Endocrinology

Background:

  • Atherosclerosis is a leading cause of cardiovascular disease in adults.
  • Subclinical atherosclerosis signs are detected in pediatric diabetic patients.
  • This study longitudinally observes atherosclerosis progression in this group.

Purpose of the Study:

  • To assess the progression of subclinical atherosclerosis in diabetic children over a two-year period.
  • To identify factors associated with atherosclerosis progression in this pediatric cohort.
  • To evaluate the impact of lifestyle counseling and ACE inhibitors on atherosclerosis progression.

Main Methods:

  • Longitudinal observation of 27 diabetic children (mean age 14.6 yrs) with initial increased carotid artery intima-media thickness (IMT).
  • Reevaluation after 2 years, with 5 patients on ACE inhibitors.
  • Detailed lifestyle, sports, and nutritional counseling provided to all participants.

Main Results:

  • Mean IMT showed a significant increase (0.49 to 0.51 mm, p < 0.05) but remained comparable to normal values.
  • IMT progression occurred in 48% of patients (13/27).
  • Patients with IMT progression had higher hemoglobin A1c (HbA1c) and systolic blood pressure (SBP).

Conclusions:

  • Mean IMT progression in diabetic children over 2 years did not exceed physiological increase.
  • Higher HbA1c and SBP are associated with IMT progression in this group.
  • Controlling atherogenic risk factors is crucial for preventing subclinical atherosclerosis progression in diabetic children.
Abstract

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