Endothelial Dysfunction and Diabetes Related Complications in Adolescents with Type 1 Diabetes

Introduction: Patients with Type 1 Diabetes (T1D) are at high risk of developing vascular complications. Endothelial Dysfunction (ED) is the early reversible stage of vascular disease. Aim: Poor Diabetic control is associated with ED. Based on a hypothesis we aimed to determine the relationship between metabolic control and endothelial function in a cohort of adolescents with T1D. Methods: 42 adolescents with T1D were recruited. Weights, heights and BMI were recorded. Blood pressure was measured, followed by assessment of Reactive hyperaemia index (RHI) by Endo-PAT. Fasting blood samples were taken for evaluation of HbA1c, liver, renal function, lipid profile. Inflammatory markers (adiponectin, leptin, thrombomodulin, serum Intravascular Adhesion Molecules (sICAM), E-Selectin and p-Selectin) were measured in 20 patients. Urinary microalbumin to creatinine ratio measured. Participants completed a physical activity questionnaire. Baseline data included the date of diagnosis, duration of diabetes, current insulin dose, insulin regimen, daily screen time and relevant family history of early cardiovascular disease. Results: Reactive hyperaemia index correlated with age. Thirteen adolescents (31%) had low RHI, suggesting relatively impaired endothelial function. Lower RHI correlated with higher diastolic blood pressure (r=-0.34) and p-Selectin level (r=-0.3) suggesting impairment in vascular health. Poor metabolic control was associated with impaired lipid profile (r=0.55), higher diastolic blood pressure (r=0.38) and higher level of inflammatory markers Pselectin (r=0.55). Active life style was associated with improved blood pressure (r=-0.35) and lipid profile (r=-0.39).