青少年1型糖尿病患者的血管和心肌结构与功能：心脏病学研究

IF 3.9 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pediatric Diabetes Pub Date : 2023-08-24 DOI:10.1155/2023/8662038

Soren Harnois-Leblanc, Vanessa McNealis, M. Friedrich, J. Bigras, A. Van Hulst, A. Nuyt, T. Barnett, A. Benedetti, M. Mathieu, V. Drapeau, M. Sylvestre, M. Henderson

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引用次数: 0

摘要

介绍尽管1型糖尿病患者患心血管疾病（CVD）的风险增加，但在这一人群中，很少有研究使用青春期早期标志物来调查CVD的发展。我们比较了患有和不患有1型糖尿病的青少年的危险因素（血压（BP）和血脂异常）和心血管疾病的早期标志物，并探讨了性别对效果的影响。方法。一项横断面研究，使用CARDEA研究中心血管疾病风险的数据。我们在圣贾斯汀大学医院中心招募了100名患有1型糖尿病的青少年和97名无糖尿病的青少年（14-18岁）。我们通过颈动脉-股动脉脉搏波速度测量动脉硬度，通过肱动脉血流介导的扩张试验测量内皮功能，以及通过心脏MRI测量左心室（LV）质量、乳头状质量和壁厚。我们使用多变量线性回归模型来评估1型糖尿病对每种结果的影响，并根据年龄、性别、种族、肥胖和家庭收入进行调整。后果患有1型糖尿病的青少年有0.21个标准差（SD）（95%CI:0.04；0.38），舒张压z评分（zDBP）高0.21 mmol/L（95%置信区间：0.02；0.40）基于加速度的低密度脂蛋白胆固醇（LDL-c）水平升高，甘油三酯水平升高17%（95%置信度：4；29），内皮功能降低（−77.4 cm/s2，95%置信区间：−133.1；−21.6）。与健康同龄人相比，患有1型糖尿病的女孩的收缩压z评分（zSBP）较高，患有1号糖尿病的男孩的左心室质量和壁厚较低。结论。除了血压升高和血脂异常外，与未患糖尿病的青少年相比，患有1型糖尿病的青少年还表现出内皮功能障碍和心脏结构改变（男孩），这表明CVD预防应在疾病早期纳入1型糖尿病管理。

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Vascular and Myocardial Structure and Function in Adolescents with Type 1 Diabetes: The CARDEA Study

Introduction. Despite heightened risk of cardiovascular disease (CVD) among individuals with type 1 diabetes, few studies in this population have investigated the development of CVD using early markers in adolescence. We compared risk factors (blood pressure (BP) and dyslipidemia) and early markers of CVD between adolescents with and without type 1 diabetes and explored effect modification by sex. Methods. Cross-sectional study using data from the CARdiovascular Disease risk in pEdiatric type 1 diAbetes (CARDEA) study. We recruited 100 adolescents with type 1 diabetes at the Sainte-Justine University Hospital Center and 97 adolescents without diabetes (14–18 years). We measured arterial stiffness by carotid-femoral pulse wave velocity, endothelial function by brachial artery flow-mediated dilation test, as well as left ventricular (LV) mass, papillary mass, and wall thickness by cardiac MRI. We used multivariable linear regression models to assess the impact of type 1 diabetes on each outcome adjusting for age, sex, ethnicity, adiposity, and familial income. Results. Adolescents with type 1 diabetes had 0.21 standard deviations (SD) (95% CI: 0.04; 0.38) higher diastolic blood pressure z-score (zDBP), 0.21 mmol/L (95% CI: 0.02; 0.40) higher low-density lipoprotein cholesterol (LDL-c) levels, and 17% (95% CI: 4; 29) higher triglyceride levels and lower endothelial function based on acceleration (−77.4 cm/s2, 95% CI: −133.1; −21.6) compared with adolescents without diabetes. Girls with type 1 diabetes had higher systolic blood pressure z-score (zSBP), and boys with type 1 diabetes had lower LV mass and wall thickness compared to healthy peers. Conclusions. In addition to higher BP and abnormal lipid profiles, adolescents with type 1 diabetes present endothelial dysfunction and alterations in cardiac structure (in boys) compared to adolescents without diabetes, suggesting that CVD prevention should be incorporated into type 1 diabetes management early in the disease.

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来源期刊

Pediatric Diabetes 医学-内分泌学与代谢

CiteScore

6.60

自引率

14.70%

发文量

141

审稿时长

4-8 weeks

期刊介绍： Pediatric Diabetes is a bi-monthly journal devoted to disseminating new knowledge relating to the epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes in childhood and adolescence. The aim of the journal is to become the leading vehicle for international dissemination of research and practice relating to diabetes in youth. Papers are considered for publication based on the rigor of scientific approach, novelty, and importance for understanding mechanisms involved in the epidemiology and etiology of this disease, especially its molecular, biochemical and physiological aspects. Work relating to the clinical presentation, course, management and outcome of diabetes, including its physical and emotional sequelae, is considered. In vitro studies using animal or human tissues, whole animal and clinical studies in humans are also considered. The journal reviews full-length papers, preliminary communications with important new information, clinical reports, and reviews of major topics. Invited editorials, commentaries, and perspectives are a regular feature. The editors, based in the USA, Europe, and Australasia, maintain regular communications to assure rapid turnaround time of submitted manuscripts.