Background: Diabetes mellitus is characterized by a very high prevalence of atherosclerotic disease. Aims of this study were to determine arterial compliance parameters in type 1 diabetes (T1D) patients as an expression of early pre-clinical endothelial dysfunction and to evaluate the impact of glucose exposure parameters such as the duration of diabetes and glycosylated haemoglobin (HbA(1c)) on the risk of developing alterations in vascular compliance.
Methods: 23 patients with uncomplicated type 1 diabetes (mean age: 32.78 +/- 9.06 years, mean disease duration: 10.78 +/- 7.51 years, mean HbA(1c) levels: 7.7 +/- 1.9) and 26 age- and sex-matched healthy subjects (mean age: 32.3 +/- 8.51 years) were recruited. In these subjects, we evaluated arterial compliance by calibrated tonometry (HDI/Pulsewave() CR-2000). Parameters included the following: large artery elasticity (C1), small artery elasticity (C2), systemic vascular resistance (SVR) and total vascular impedance (TVI).
Results: Patients with longer duration of T1D (>10 years) showed significant alterations in C2 (4.97 +/- 2.7 mL/mmHg x 100) and in SVR (1464.67 +/- 169.16 dina x s x cm(-5)) when compared with both healthy individuals (C2: 8.28 +/- 2.67 mL/mmHg x 100, p = 0.001; SVR: 1180.58 +/- 151.55 dina x s x cm(-5), p = 0.01) and patients with recent-onset disease (<or=10 years) (C2: 10.02 +/- 3.6 mL/mmHg x 100, p < 0.001; SVR: 1124.18 +/- 178.5 dina x s x cm(-5), p < 0.000). Both disease duration and HbA(1c) independently predicted impaired arterial compliance.
Conclusions: Young adult T1D patients with no signs of disease complication have detectable vessel wall abnormalities, particularly of small arteries, suggestive of hyperglycaemia-related early endothelial dysfunction.