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Children With Type 1 Diabetes Have Delayed Flow-Mediated Dilation

Sarveshinee Pillay1, Jemma Anderson1, Jennifer Couper1

  • 1Robinson Research Institute and Discipline of Paediatrics, The University of Adelaide, Adelaide, South Australia, Australia; Endocrinology and Diabetes Centre, Women's and Children's Hospital, North Adelaide, South Australia, Australia.

Canadian Journal of Diabetes
|July 30, 2017
PubMed

Insights

Children with type 1 diabetes show delayed endothelial dysfunction, a marker of vascular abnormalities. Standard flow-mediated dilation (FMD) at 60 seconds is the best indicator for cardiovascular disease risk in these children.

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.
Abstract

Keywords:
childrendiabète de type 1dilatation induite par le fluxenfantsflow-mediated dilationtype 1 diabetes

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