Diagnosis of vascular remodeling in children with type 1 diabetes mellitus

Diabetes mellitus is among the top ten causes of mortality in the general population worldwide. One of the important target organs in type 1 diabetes mellitus is the endothelium. Atherosclerotic changes can lead to increased stiffness of arterial walls. Higher arterial stiffness is an independent risk factor for cardiovascular complications and mortality in various population groups, including adults with type 1 diabetes mellitus.

Objective. To assess arterial stiffness parameters in children with type 1 diabetes mellitus in order to identify early signs of vascular remodeling.

Materials and methods. The study included 62 children with type 1 diabetes mellitus (mean age 11.15 ± 3.74 years) and 62 children in the control group. All participants underwent 24-hour ambulatory blood pressure monitoring with assessment of pulse wave velocity, augmentation index (AIx), ambulatory arterial stiffness index (AASI), and other parameters. The type 1 diabetes mellitus group was stratified by disease duration, glycated hemoglobin (HbA1c) level, and total cholesterol.

Results. Children with type 1 diabetes mellitus showed a statistically significant increase in all main arterial stiffness parameters compared with the control group. It was established that a longer disease duration (≥ 5 years) was associated with higher values of mean and maximum pulse wave velocity and of the ambulatory arterial stiffness index. Unsatisfactory glycemic control (HbA1c ≥ 7.1 %) and elevated total cholesterol (≥ 4.4 mmol/L) also had a statistically significant effect on increased vascular stiffness (p < 0.05).

Conclusion. Children with type 1 diabetes mellitus show an early and significant increase in arterial stiffness, indicating the onset of vascular remodeling. The identified dependence on disease duration, glycemic control, and dyslipidemia underscores the need for early monitoring of these parameters for timely prevention of cardiovascular complications.

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