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Decreased Flow-Mediated Dilatation in Children With Type 1 Diabetes: A Systematic Review and Meta-Analysis

Lei Cao1, Miao Hou1, Wanping Zhou1

  • 1Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China.

Angiology
|April 26, 2021
PubMed

Insights

Children with type 1 diabetes (T1DM) show impaired endothelial function, indicated by lower flow-mediated dilatation (FMD). This finding suggests an increased risk for cardiovascular disease in this young population.

Area of Science:

  • Pediatrics
  • Cardiology
  • Endocrinology

Background:

  • Type 1 diabetes (T1DM) is a significant risk factor for cardiovascular disease (CVD).
  • Flow-mediated dilatation (FMD) is a key noninvasive indicator of endothelial function and a predictor of future CVD.
  • The status of FMD in children with T1DM remains a subject of debate.

Purpose of the Study:

  • To conduct a meta-analysis to determine if FMD is impaired in children diagnosed with T1DM.
  • To synthesize existing research to provide a clearer understanding of endothelial function in pediatric T1DM.

Main Methods:

  • A systematic literature search was performed across PubMed, EMBASE, Cochrane Library, and Web of Science.
  • Studies comparing FMD in T1DM children and healthy controls were included.
  • Quality assessment used the Newcastle-Ottawa scale; data were pooled using random-effects models.

Main Results:

  • The meta-analysis included 19 studies with 1245 T1DM patients and 872 healthy controls.
  • Children with T1DM exhibited significantly lower FMD compared to healthy controls (WMD: -2.58; 95% CI: -3.36 to -1.81; P < .001).
  • Meta-regression identified low-density lipoprotein cholesterol levels as a factor influencing the FMD difference.

Conclusions:

  • Children with T1DM demonstrate impaired endothelial function.
  • This impairment suggests a heightened risk for developing cardiovascular disease later in life.
  • Early detection and management of endothelial dysfunction in T1DM children are crucial for CVD prevention.

Keywords:
childrenendothelial dysfunctionflow-mediated dilatationmeta-analysistype 1 diabetes

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