Central Systolic Blood Pressure Is Associated With Early Vascular Damage in Children and Adolescents With Type 1 Diabetes

Angela Tagetti; Claudia A Piona; Denise Marcon; Alice Giontella; Lorella Branz; Stefano Bortolotti; Anita Morandi; Claudio Maffeis; Cristiano Fava

doi:10.3389/fcvm.2021.606103

Central Systolic Blood Pressure Is Associated With Early Vascular Damage in Children and Adolescents With Type 1 Diabetes

Front Cardiovasc Med. 2021 Sep 7:8:606103. doi: 10.3389/fcvm.2021.606103. eCollection 2021.

Authors

Angela Tagetti¹, Claudia A Piona², Denise Marcon¹, Alice Giontella¹, Lorella Branz¹, Stefano Bortolotti¹, Anita Morandi², Claudio Maffeis², Cristiano Fava¹

Affiliations

¹ Department of Medicine, General Medicine and Hypertension Unit, University of Verona, Verona, Italy.
² Pediatric Diabetes and Metabolic Disorders Unit, Regional Center for Pediatric Diabetes, University City Hospital of Verona, Verona, Italy.

Abstract

Objective of the study: This study aimed to test the effect of multiple cardiovascular risk factors on subclinical indices of atherosclerosis in children and adolescents with type 1 diabetes (T1D). Methods: Carotid intima-media thickness (cIMT), carotid distensibility coefficient (cDC), and carotid-femoral pulse wave velocity (PWV) were measured in children and adolescents with T1D, in a follow-up at the outpatient clinics of Verona. Blood pressure (BP; both central and peripheral), metabolic and other cardiovascular risk factors were evaluated in multivariate linear regressions to assess the association with the measured indices of subclinical vascular damage. Results: One hundred and twenty-six children and adolescents were included. cIMT was above the 95th percentile for age and height in 60.8% of the population, whereas 26% of the sample had cDC impairment (less than the 5th percentile) and 4.8% had an elevated PWV. Independent determinants of cIMT according to the regression models were only gender type of glucose monitoring and central systolic BP (cSBP). PWV was associated with age, sex, heart rate, and cSBP; cDC with age and both cSBP and, alternatively, peripheral BP (pBP). Neither pBP nor any of the tested metabolic parameters, including glycated hemoglobin, was associated with PWV and cIMT. Conclusions: A high proportion of early vascular damage, especially an increased cIMT, is present in children and adolescents with T1D in whom cSBP seems to be a common determinant. In children and adolescents with T1DM, a special focus should be on hemodynamic risk factors beyond metabolic ones.

Keywords: adolescent; arterial pressure; carotid intima-media thickness; carotid-femoral pulse wave velocity; child; risk factors; type 1 diabetes.