Impaired Coronary Arterial Dilation in Youth-Onset Type 2 Diabetes

Young adults with type 2 diabetes (T2D-Y) have increased risk of subclinical atherosclerotic cardiovascular disease (ASCVD) . Cardiac magnetic resonance imaging (MRI) may guide risk stratification by noninvasively quantifying coronary wall thickness (CWT, an indicator of ASCVD) and endothelial function (arterial dilation during isometric hand grip exercise, IHE) . The utility of these novel MRI biomarkers in T2D-Y is unknown. We hypothesized that T2D-Y would be associated with increased CWT and impaired endothelial function. In T2D-Y (6 male, age 19.8±1.6y, BMI 37±7kg/m2) and 12 healthy controls (5 male, age 22.7±2.9 y, BMI 24±5 kg/m2) we measured CWT and coronary and brachial dilation during IHE with a 3.0 Tesla MRI. T2D-Y had higher HbA1c (6.5 ± 0.8 vs. 5.1 ± 0.6%, P<0.01) , C reactive protein (5.16 ± 5.35 vs. 1.25 ± 2.25 mg/L) , systolic blood pressure (129±13 vs. 116±14 mmHg) , heart rate (84±13 vs. 72±9 beats/min (all P<0.05) . T2D-Y had lower HDL cholesterol (40±vs. 66±15 mg/dL, P=0.002) but similar LDL-cholesterol and triglycerides. CWT was not different (1.26±0.12 vs. 1.34±0.14 mm, P=0.18) but coronary and brachial arterial dilation was impaired in T2D-Y (Figure) . Overall, compared to health peers, T2D-Y had comparable CWT but impaired coronary and brachial arterial dilation occurred in the absence of traditional risk factors such as severe hyperglycemia, frank hypertension or dyslipidemia. Disclosure A. Villalobos-Perez: None. J. Feeley: None. K.Z. Abd-Elmoniem: None. K.B. Dietsche: None. J.R. Matta: None. M.S. Stagliano: None. L. Mabundo: None. E.L. Shouppe: None. M. Walter: None. S.T. Chung: None. Funding NIDDK/NIH Intramural Research Program