Children With Type 1 Diabetes Have Delayed Flow-Mediated Dilation

Area of Science:

• Pediatric Endocrinology
• Cardiovascular Research
• Vascular Biology

Background:

• Children with type 1 diabetes (T1D) experience accelerated atherosclerosis and endothelial dysfunction.
• Early endothelial dysfunction is typically measured by flow-mediated dilation (FMD) at 60 seconds post-ischemic stress.
• Delayed FMD, assessed beyond 60 seconds, may offer a more sensitive marker for cardiovascular risk, but data in pediatric T1D is lacking.

Purpose of the Study:

• To compare early (60-second) and delayed (120-second) FMD in children with T1D versus healthy controls.
• To investigate the prevalence and significance of delayed FMD in pediatric T1D.
• To determine the most effective FMD measurement for identifying cardiovascular risk in children with T1D.

Main Methods:

• A cohort of 66 children (38 with T1D, 28 healthy controls), aged 13.5±2.8 years, was studied.
• Brachial artery FMD was assessed at 60 seconds (FMD60s) and 120 seconds (FMD120s) post-ischemic stress.
• Delayed FMD was defined as peak FMD at 120 seconds.

Main Results:

• Delayed FMD occurred in 8 children with T1D and 1 healthy control (p=0.019).
• Children with T1D and delayed FMD exhibited significantly lower FMD60s compared to those without delayed FMD (2.50% vs. 6.14%, p=0.02).
• Children with T1D had lower FMD60s than controls (5.38% vs. controls, p=0.03) but similar FMD120s (7.56% vs. controls, p=0.47).

Conclusions:

• Delayed FMD patterns are present in children with type 1 diabetes, indicating more severe vascular abnormalities.
• The standard 60-second FMD measurement remains the superior marker for identifying children at increased risk of cardiovascular disease.
• These findings highlight the importance of early vascular assessment in pediatric T1D management.