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Pediatric Cardiology
Erschienen in: Pediatric Cardiology 6/2014

01.08.2014 | Original Article

Subclinical Vascular Endothelial Dysfunctions and Myocardial Changes With Type 1 Diabetes Mellitus in Children and Adolescents

verfasst von: Azza A. Eltayeb, Faisal-Alkhateeb Ahmad, Douaa M. Sayed, Amany M. Osama

Erschienen in: Pediatric Cardiology | Ausgabe 6/2014

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Abstract

Vascular endothelial dysfunction, accelerated thickening of arterial intima, and changes in ventricular functions contribute to increased cardiovascular morbidity in type 1 diabetes mellitus (T1DM). This study aimed to investigate the functional-structural changes in the arteries and myocardium together with affection of highly sensitive C-reactive protein (hsCRP), circulating endothelial cells (CECs), and vitamin C levels in children with T1DM. Also, to test the association with early atherosclerotic changes. The study included 30 children with a diagnosis of T1DM and 30 healthy subjects matched by sex, age, and body mass index. Serum lipids, HbA1c, hsCRP, vitamin C, and CECs were detected. Corrected QT interval (QTc), cardiac dimensions, and left ventricular (LV) functions were assessed using conventional echocardiography. Noninvasive ultrasound was used to measure brachial artery flow-mediated dilation (FMD) responses and carotid intima-media thickness (IMT). The QTc interval was significantly higher in the diabetic patients than in the control subjects (P < 0.001). The findings showed LV diastolic dysfunction as reflected by significantly lower early peak flow velocity, decreased E/A ratio, increased early filling deceleration time (DcT), and prolonged isovolumic relaxation time (IVRT) (P < 0.001 for each). The children with diabetes had a significantly lower FMD response, increased IMT, lower vitamin C level, higher hsCRP, and higher CEC compared with the control subjects (P < 0.001 for each). A positive correlation between CEC and HbA1c was found (P = 0.004). An alteration in myocardial function and endothelial dysfunction may begin early with the association of early atherosclerotic changes. These changes are accelerated when glycemic control is poor. The authors recommend early and close observation of children with diabetes for any alterations in cardiac and vascular endothelial function. Vitamin C supplementation may reduce the risk of complications.
Literatur
1.
Asicioglu E, Yavuz DG, Koc M, Ozben B, Yazici D, Deyneli O, Akalin S (2010) Circulating endothelial cells are elevated in patients with type 1 diabetes mellitus. Eur J Endocrinol 162:711–717CrossRefPubMed
2.
Ayla G, Tolga O, Olcay G, Murat A, Kemal B (2010) Association between the corrected QT interval and carotid artery intima-media thickness in obese children. J Clin Res Pediatr Endocrinol 2:21–27CrossRef
3.
Babar GS, Zidan H, Widlansky ME et al (2011) Impaired endothelial function in preadolescent children with type 1 diabetes. Diabetes Care 34:681–685PubMedCentralCrossRefPubMed
4.
Bazett HC (1920) An analysis of the time relationships of electrocardiograms. Heart 7:353–357
5.
Berenson GS, Bogalusa Heart Study Research Group (2002) Childhood risk factors predict adult risk associated with subclinical cardiovascular disease: the Bogalusa heart study. Am J Cardiol 90:3L–7LCrossRef
6.
Bert S, Sara H, Daniel DE, Marc V et al (2006) Glycemia and corrected QT interval prolongation in young type 1 diabetic patients. Diabetes Care 29:427CrossRef
7.
Dalle-Donne I, Ranieri R, Roberto C, Daniela G, Aldo M (2006) Biomarkers of oxidative damage in human disease. Clin Chem 52:601–623CrossRefPubMed
8.
9.
de Simone G, Mureddu GF, Vaccaro O et al (2000) Cardiac abnormalities in type 1 diabetes. Ital Heart J 1:493–499PubMed
10.
Di Cori AD, Di Bello V, Miccoli R et al (2007) Left ventricular function in normotensive young adults with well-controlled type 1 diabetes mellitus. Am J Cardiol 99:84–90CrossRefPubMed
11.
Dimitriadis E, Griffin M, Owens D, Johnson A, Collins P, Tomkin GH (1995) Oxidation of low-density lipoprotein in NIDDM: its relationship to fatty acid composition. Diabetologia 38:1300–1306CrossRefPubMed
12.
Donahue RP, Orchard TJ (1992) Diabetes mellitus and macrovascular complications: an epidemiological perspective. Diabetes Care 15:1141–1155CrossRefPubMed
13.
Fang ZY, Prins JB, Marwick TH (2004) Diabetic cardiomyopathy: evidence, mechanisms, and therapeutic implications. Endocr Rev 25:543–567CrossRefPubMed
14.
Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18:499–502PubMed
15.
From AM, Scott CG, Chen HH (2009) Changes in diastolic dysfunction in diabetes mellitus over time. Am J Cardiol 103:1246–1463
16.
Galina M, Angelika S (2011) Influence of metabolic decompensation in children with diabetes mellitus type 1 on changes of QT interval. Endocr Abstr 25:137
17.
Głowińska-Olszewska B, Urban M, Peczyńska J, Koput A (2007) hsCRP protein in children and adolescents with diabetes type 1. Pediatr Endocrinol Diabetes Metab 13:79–84PubMed
18.
Halliwell B (2001) Role of free radicals in the neurodegenerative diseases: therapeutic implications for antioxidant treatment (review). Drugs Aging 18:685–716CrossRefPubMed
19.
Halliwell B, Whiteman M (2004) Measuring reactive species and oxidative damage in vivo and in cell culture: how should you do it and what do the results mean? (review). Br J Pharmacol 142:231–255PubMedCentralCrossRefPubMed
20.
Heilman K, Zilmer M, Zilmer K, Lintrop M, Kampus P, Kals J, Tillmann V (2009) Arterial stiffness, carotid artery intima-media thickness, and plasma myeloperoxidase level in children with type 1 diabetes. Diabetes Res Clin Pract 84:168–173CrossRefPubMed
21.
Jane EW, Jonathan R, Ajay V, Mihai G, Sanjiv JS (2011) Usefulness of electrocardiographic QT interval to predict left ventricular diastolic dysfunction. Am J Cardiol 108:1760–1766CrossRef
22.
Järvisalo MJ, Jartti L, Näntö-Salonen K, Irjala K, Rönnemaa T, Hartiala JJ, Celermajer DS, Raitakari OT (2001) Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation 104:2943–2947CrossRefPubMed
23.
Järvisalo MJ, Putto-Laurila A, Jartti L, Lehtimäki T, Solakivi T, Rönnemaa T, Raitakari OT (2002) Carotid intima-media thickness in children with type 1 diabetes. Diabetes 51:493–498CrossRefPubMed
24.
Järvisalo MJ, Rönnemaa T, Volanen I et al (2002) Brachial artery dilatation responses in healthy children and adolescents. Am J Physiol Heart Circ Physiol 282:H87–H92PubMed
25.
Järvisalo MJ, Lehtimäki T, Raitakari OT (2004) Determinants of arterial nitrate-mediated dilatation in children: role of oxidized low-density lipoprotein, endothelial function, and carotid intima-media thickness. Circulation 109:2885–2889CrossRefPubMed
26.
Järvisalo MJ, Raitakari M, Toikka JO, Putto-Laurila A, Rontu R, Laine S, Lehtimäki T, Rönnemaa T, Viikari J, Raitakari OT (2004) Endothelial dysfunction and increased arterial intima-media thickness in children with type 1 diabetes. Circulation 109:1750–1755CrossRefPubMed
27.
Jin SM, Noh CI, Yang SW et al (2008) Endothelial dysfunction and microvascular complications in type 1 diabetes mellitus. J Korean Med Sci 23:77–82PubMedCentralCrossRefPubMed
28.
Kanters SD, Algra A, van Leeuwen MS, Banga JD (1997) Reproducibility of in vivo carotid intima-media thickness measurements: a review. Stroke 28:665–671CrossRefPubMed
29.
30.
Khan SS, Solomon MA, McCoy JP Jr (2005) Detection of circulating endothelial cells and endothelial progenitor cells by flow cytometry. Cytometry B 64:1–8CrossRef
31.
32.
King GL, Loeken MR (2004) Hyperglycemia-induced oxidative stress in diabetic complications. Histochem Cell Biol 122:333–338CrossRefPubMed
33.
34.
Lu Z, Abe J, Taunton J et al (2008) Reactive oxygen species-induced activation of p90 ribosomal S6 kinase prolongs cardiac repolarization through inhibiting outward K+ channel activity. Circ Res 103:269–278PubMedCentralCrossRefPubMed
35.
Makimattila S, Liu ML, Vakkilainen J, Schlenzka A, Lahdenpera S, Syvanne M, Mantysaari M, Summanen P, Bergholm R, Taskinen MR, Yki-Jarvinen H (1999) Impaired endothelium-dependent vasodilation in type 2 diabetes: relation to LDL size, oxidized LDL, and antioxidants. Diabetes Care 22:973–981CrossRefPubMed
36.
Maritim AC, Sanders RA, Watkins JB (2003) Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol 17:24–38CrossRefPubMed
37.
Mayet J, Shahi M, McGrath K, Poulter NR, Sever PS, Foale RA, Thom SA (1996) Left ventricular hypertrophy and QT dispersion in hypertension. Hypertension 28:791–796CrossRefPubMed
38.
McClung JA, Naseer N, Saleem M, Rossi GP, Weiss MB, Abraham NG, Kappas A (2005) Circulating endothelial cells are elevated in patients with type 2 diabetes mellitus independently of HbA(1)c. Diabetologia 48:345–350CrossRefPubMed
39.
Nicolls MR, Haskins K, Flores SC (2007) Oxidant stress, immune dysregulation, and vascular function in type I diabetes. Antioxid Redox Signal 9:879–889CrossRefPubMed
40.
Odermarsky M, Lykkesfeldt J, Liuba P (2009) Poor vitamin C status is associated with increased carotid intima-media thickness, decreased microvascular function, and delayed myocardial repolarization in young patients with type 1 diabetes. Am J Clin Nutr 90:447–452CrossRefPubMed
41.
Park MK (2008) Pediatric cardiology for practitioners. Noninvasive techniques (Chap. 6), 5th edn., An imprint of Elsevier, Part 2: Special tools in evaluation of cardiac patientsElsevier, Mosby
42.
Park MK (2008) Pediatric cardiology for practitioners. Dyslipidemia and other cardiovascular risk factors (Chap. 6), 5th edn., An imprint of Elsevier, Part 7: Special problemsElsevier, Mosby
43.
Perségol L, Foissac M, Lagrost L et al (2007) HDL particles from type 1 diabetic patients are unable to reverse the inhibitory effect of oxidised LDL on endothelium-dependent vasorelaxation. Diabetologia 50:2384–2387CrossRefPubMed
44.
Pirro M, Bagaglia F, Paoletti L, Razzi R, Mannarino MR (2008) Hypercholesterolemia-associated endothelial progenitor cell dysfunction. Ther Adv Cardiovasc Dis 2:329–339CrossRefPubMed
45.
Pozza RD, Bechtold S, Bonfig W et al (2007) Age of onset of type 1 diabetes in children and carotid intima medial thickness. J Clin Endocrinol Metab 92:2053–2057CrossRefPubMed
46.
47.
Sanguinetti MC, Tristani-Firouzi M (2006) hERG potassium channels and cardiac arrhythmia. Nature 440:463–469CrossRefPubMed
48.
Selvin E, Coresh J, Golden SH, Boland LL, Brancati FL, Steffes MW (2005) Glycemic control, atherosclerosis, and risk factors for cardiovascular disease in individuals with diabetes: the Atherosclerosis Risk in Communities Study. Diabetes Care 28:1965–1973CrossRefPubMed
49.
Sibal L, Aldibbiat A, Agarwal SC, Mitchell G, Oates C, Razvi S, Weaver JU, Shaw JA, Home PD (2009) Circulating endothelial progenitor cells, endothelial function, carotid intima-media thickness and circulating markers of endothelial dysfunction in people with type 1 diabetes without macrovascular disease or microalbuminuria. Diabetologia 52:1464–1473CrossRefPubMed
50.
Sies H (1991) Oxidative stress: oxidants and antioxidants. Academic Press, New York
51.
Singh TP, Groehn H, Kazmers A (2003) Vascular function and carotid intima-medial thickness in children with insulin-dependent diabetes mellitus. J Am Coll Cardiol 41:661–665CrossRefPubMed
52.
Snell-Bergeon JK, West NA, Mayer-Davis EJ, Liese AD et al (2010) Inflammatory markers are increased in youth with type 1 diabetes: The SEARCH case–control study. J Clin Endocrinol Metab 95:2868–2876PubMedCentralCrossRefPubMed
53.
Stakos DA, Schuster DP, Sparks EA, Wooley CF, Osei K, Boudoulas H (2005) Cardiovascular effects of type 1 diabetes mellitus in children. Angiology 56:311–317CrossRefPubMed
54.
Stettler C, Bearth A, Allemann S et al (2007) QTc interval and resting heart rate as long-term predictors of mortality in type 1 and type 2 diabetes mellitus: a 23-year follow-up. Diabetologia 50:186–194CrossRefPubMed
55.
Strohmer B, Pichler M, Iglseder B, Paulweber B (2005) Relationship of QT interval duration with carotid intima-media thickness in a clinically healthy population undergoing cardiovascular risk screening. J Intern Med 257:238–246CrossRefPubMed
56.
van Heerebeek L, Hamdani N, Handoko ML et al (2008) Diastolic stiffness of the failing diabetic heart: importance of fibrosis, advanced glycation end products, and myocyte resting tension. Circulation 117:43–51CrossRefPubMed
57.
Will JC, Byers T (1996) Does diabetes mellitus increase the requirement for vitamin C? Nutr Rev 54:193–202CrossRefPubMed
58.
Wojcik M, Rudzinski A, Starzyk J (2010) Left ventricular diastolic dysfunction in adolescents with type 1 diabetes reflects the long- but not short-term metabolic control. J Pediatr Endocrinol Metab 23:1055–1064CrossRefPubMed
59.
Woywodt A, Blann AD, Kirsch T, Erdbruegger U, Banzet N, Haubitz M, Dignat-George F (2006) Isolation and enumeration of circulating endothelial cells by immunomagnetic isolation: proposal of a definition and a consensus protocol. J Thromb Haemost 4:671–677CrossRefPubMed
60.
Zhang Y, Xiao J, Wang H et al (2006) Restoring depressed hERG K+ channel function as a mechanism for insulin treatment of abnormal QT prolongation and associated arrhythmias in diabetic rabbits. Am J Physiol Heart Circ Physiol 291:H1446–H1455CrossRefPubMed
61.
Zou MH, Shi C, Cohen RA (2002) High glucose via peroxynitrite causes tyrosine nitration and inactivation of prostacyclin synthase that is associated with thromboxane/prostaglandin H(2) receptormediated apoptosis and adhesion molecule expression in cultured human aortic endothelial cells. Diabetes 51:198–203CrossRefPubMed
Metadaten
Titel
Subclinical Vascular Endothelial Dysfunctions and Myocardial Changes With Type 1 Diabetes Mellitus in Children and Adolescents
verfasst von
Azza A. Eltayeb
Faisal-Alkhateeb Ahmad
Douaa M. Sayed
Amany M. Osama
Publikationsdatum
01.08.2014
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 6/2014
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-014-0883-9

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