Arterial stiffness in children and adolescents with type 1 Diabetes mellitus or excess weight

Abstract BACKGROUND The relationship between pediatric obesity or Type 1 Diabetes Mellitus (T1DM) and cardiovascular disease in adulthood is well established, with the pathophysiological mechanisms being already present in childhood. Arterial stiffness is a strong, independent predictor of cardiovascular disease in adulthood. In this study we evaluated arterial stiffness indices such as pulse wave velocity (PWV) and central blood pressure (cBP) in children and adolescents with T1DM or excess weight, in order to detect subclinical vascular alterations at a very early stage. METHODS A total of 199 children and adolescents aged 2-18 years participated in the study, including 96 with T1DM, 49 with overweight or obesity, and 54 healthy controls. PWV and cBP was measured using the automated oscillometric device Mobil-O-Graph. RESULTS Systolic BP (SBP) and central SBP (cSBP) were overall and especially in those >10 years of age, significantly higher in both patients with overweight/obesity and those with T1DM compared to controls. Furthermore, overweight/obesity patients had higher SBP, cSBP and cDBP compared to T1DM patients, whereas DBP was significantly higher only in overweight/obesity patients compared to controls. Pulse wave velocity values were also significantly higher in both overweight/obesity patients and those with T1DM compared to controls, while overweight/obesity patients had higher PWV when compared to patients with T1DM. CONCLUSIONS Impaired arterial elasticity was found in children and adolescents older than 10 years, with T1DM and overweight/obesity, particularly in the latter. PWV could potentially serve as diagnostic tool for impaired vascular health in children and adolescents with T1DM or overweight/obesity.