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Intima-media thickness at different arterial segments in pediatric type 1 diabetes patients and its relationship with

Christian Lilje1, Julie C Cronan2, Elridge J Schwartzenburg2

  • 1Department of Pediatrics (Cardiology), Louisiana State University Health Sciences Center, Children's Hospital, New Orleans, Louisiana.

Pediatric Diabetes
|July 1, 2017
PubMed

Insights

Type 1 diabetes patients show early atherosclerosis. Aortic and femoral intima-media thickness (IMT) better detect these changes in children than carotid or brachial IMT.

Area of Science:

  • Cardiovascular Research
  • Pediatric Endocrinology
  • Medical Imaging

Background:

  • Type 1 diabetes mellitus (T1DM) patients face increased risk of premature atherosclerosis, originating in childhood.
  • Carotid intima-media thickness (IMT) is a known marker for subclinical atherosclerosis in adults.
  • Early atherosclerotic changes manifest in the abdominal aorta, preceding other detectable signs.

Purpose of the Study:

  • To evaluate the sensitivity of brachial, femoral, and aortic IMT in detecting early macrovascular changes in pediatric T1DM patients.
  • To compare the sensitivity of these IMT measurements against the conventional carotid IMT.
  • To investigate the relationship between IMT and advanced glycation end products (AGE) in this population.

Main Methods:

  • High-resolution external ultrasound was used to measure carotid, brachial, femoral, and aortic IMT.
  • Measurements were prospectively analyzed in children and adolescents with T1DM and a control group.
  • Advanced glycation end products (AGE) were quantified using skin intrinsic fluorescence (SIF), excluding other cardiovascular risk factors.

Main Results:

  • Aortic and femoral IMT were significantly increased in T1DM patients compared to controls.
  • Carotid and brachial IMT did not show significant differences between T1DM patients and controls.
  • Elevated AGE levels in T1DM patients correlated only with aortic IMT, with this association not remaining significant after adjustments.

Conclusions:

  • Aortic IMT, followed by femoral IMT, demonstrates higher sensitivity in identifying early macrovascular changes in pediatric T1DM patients.
  • These findings suggest that aortic and femoral IMT are more effective surrogate markers for subclinical atherosclerosis in this demographic.
  • The study highlights the importance of assessing IMT in different arterial segments for early detection of cardiovascular risk in children with T1DM.
Abstract

Keywords:
advanced glycation end productsatherosclerosisdiabetes mellitusintima-media thicknesspediatrics

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