Arterial stiffness in children and adolescents with and without continuous insulin infusion
-
Cíntia Castro-Correia
,
Cláudia Moura
Abstract
Background
Arterial stiffness is a consequence of aging, but there are several diseases that contribute to this process. The evaluation of pulse wave velocity (PWV) allows a dynamic evaluation of vascular distensibility and the detection of atherosclerosis at an early stage. It was intended to evaluate the PWV in children and adolescents with type 1 diabetes mellitus (T1DM) and to compare their outcome according to the type of treatment used.
Methods
Forty-eight patients were randomly selected. Inclusion criteria: T1DM, under intensive insulin therapy (multiple daily insulin administrations [MDI] or continuous insulin infusion system [CIIS]). Exclusion criteria: existence of another chronic pathology or microvascular complications. Echocardiography was performed and three measurements of PWV were done, with their mean calculated.
Results
Most of the children and adolescents presented a PWV ≥ the 75th centile. There was a statistically significant difference for hemoglobin A1c (HbA1c) (7.8 in CIIS vs. 9 in MDI, p < 0.05). There were not statistically significant differences in the PWV between the two groups. This can be attributed to the fact that children with CIIS are those who previously presented greater glycemic instability. There was a significant correlation between PWV and disease duration (Pearson’s correlation coefficient [r] = 0.314, p = 0.036).
Conclusions
This study showed that in children and adolescents with T1DM, there is an important prevalence of arterial stiffness, translated by an increase in PWV. This increase in PWV appears to exist even in very young children with little disease evolution time.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This study was not funded.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interest: The authors declares that they have no conflict of interest.
Ethical statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This article does not contain any studies with animals performed by any of the authors.
References
1. Savant JD, Furth SL, Meyersa EC. Arterial stiffness in children: pediatric measurement and considerations. Pulse (Basel) 2014;2:69–80.10.1159/000374095Search in Google Scholar PubMed PubMed Central
2. Putarek K, Banfic L, Pasalic M, Krnic N, Uroic AS, et al. Arterial stiffness as a measure of cardiovascular risk in obese adolescents and adolescents with diabetes type 1. J Pediatr Endocrinol Metab 2018;31:1315–23.10.1515/jpem-2018-0137Search in Google Scholar PubMed
3. Santiprabhob J, Limprayoon K, Aanpreung P, Charoensakdi R, Kalpravidh RW, et al. Impact of a group-based treatment program on adipocytokines, oxidative status, inflammatory cytokines and arterial stiffness in obese children and adolescents. J Pediatr Endocrinol Metab 2018;31:733–42.10.1515/jpem-2018-0012Search in Google Scholar PubMed
4. Pereira T, Correia C, Cardoso J. Novel methods for pulse wave velocity measurement. J Med Biol Eng 2015;35:555–65.10.1007/s40846-015-0086-8Search in Google Scholar PubMed PubMed Central
5. Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006;27:2588–605.10.1093/eurheartj/ehl254Search in Google Scholar PubMed
6. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension ofthe European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34:2159–219.10.1201/b17072-61Search in Google Scholar
7. Reusz GS, Cseprekal O, Temmar M, Kis E, Cherif AB, et al. Reference values of PWV in healthy children and teenagers. Hypertension 2010;56:217–24.10.1161/HYPERTENSIONAHA.110.152686Search in Google Scholar PubMed
8. Dabelea D, Talton JW, Wadwa RP, Urbina EM, Dolan LM, et al. Cardiovascular risk factors are associated with increased arterial stiffness in youth with type 1 diabetes. The SEARCH CVD study. Diabetes Care 2013;36:3938–43.10.2337/dc13-0851Search in Google Scholar PubMed PubMed Central
9. Shah AS, Dolan LM, Lauer A, Davis C, Dabelea D, et al. Adiponectin and arterial stiffness in youth with type 1 diabetes: the search for diabetes in youth study. J Pediatr Endocrinol Metab 2012;25:717–21.10.1515/jpem-2012-0070Search in Google Scholar PubMed PubMed Central
10. Svensson J, Cerqueira C, Kjærsgaard P, Lyngsøe L, Hertel NT, et al. Danish registry of childhood and adolescent diabetes. Clin Epidemiol 2016;8:679–83. eCollection 2016.10.2147/CLEP.S99469Search in Google Scholar PubMed PubMed Central
11. Roselund S, Theilade S, Hansen TW, Andersen S, Rossing P. Treatment with subcutaneous insulin infusion is associated with lower arterial stiffness. Acta Diabetol 2014;51:955–62.10.1007/s00592-014-0619-6Search in Google Scholar PubMed
12. Peyser TA, Balo AK, Buckingham BA, Hirsch IB, Garcia A. Glycemic variability percentage: a novel method for assessing glycemic variability from continuous glucose monitor data. Diabetes Technol Ther 2018;20:6–16.10.1089/dia.2017.0187Search in Google Scholar PubMed PubMed Central
©2019 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Mini Review
- Endocrine manifestations of PHACE syndrome
- Original Articles
- Quantitation of the arginine family amino acids in the blood of full-term infants perinatally in relation to their birth weight
- Effect of supplementation with omega-3 fatty acids on hypertriglyceridemia in pediatric patients with obesity
- Pediatric diabetes inpatient care: can medical staff knowledge be improved?
- Association of lipid profile and BMI Z-score in southern Iranian children and adolescents
- Arterial stiffness in children and adolescents with and without continuous insulin infusion
- Fasting during the holy month of Ramadan among older children and adolescents with type 1 diabetes in Kuwait
- Evaluation of the relationship between short-term glycemic control and netrin-1, a urinary proximal tubular injury marker in children with type 1 diabetes
- Incidence of diabetic ketoacidosis in newly diagnosed type 1 diabetes children in western Saudi Arabia: 11-year experience
- Novel mutations and spectrum of the disease of NR0B1 (DAX1)-related adrenal insufficiency in Indian children
- Metabolic profile, cardiovascular risk factors and health-related quality of life in children, adolescents and young adults with congenital adrenal hyperplasia
- Safety and effectiveness of growth hormone therapy in infants with Prader-Willi syndrome younger than 2 years: a prospective study
- Response to sapropterin hydrochloride (Kuvan®) in children with phenylketonuria (PKU): a clinical trial
- Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A in children: a single centre experience
- Benign thyroid nodules in pediatric patients: determining best practices for repeat ultrasound evaluations
- Letter to the Editor
- Thyroid function in males with fragile X syndrome
- Case Reports
- A case of a severe reaction following the use of bisphosphonates in a patient with osteogenesis imperfecta
- Cushing disease in a patient with nonbullous congenital ichthyosiform erythroderma: lessons in avoiding glucocorticoids in ichthyosis
- Contiguous gene deletion in a Chinese family with X-linked nephrogenic diabetes insipidus: challenges in early diagnosis and implications for affected families
