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Early signs of heart disease in preadolescent children with type 1 diabetes

Cardiovascular disease is the leading cause of death in patients with diabetes. Patients with type 1diabetes have a 200 percent to 400 percent greater chance of developing cardiovascular disease than those without diabetes.

Medical College of Wisconsin researchers at Children's Hospital of Wisconsin discovered the early signs of cardiovascular disease are likely to manifest before the onset of puberty in many children with diabetes.

Those findings are published in the February 2, 2011 online version of Diabetes Care and will be in the March 2011 issue of Diabetes Care.

Led by Dr. Ramin Alemzadeh, professor of pediatrics at the college and pediatric endocrinologist at Children's Hospital of Wisconsin, and Senior Clinician Scientist at Children's Hospital's Max McGee Juvenile Diabetes Research Center, the researchers studied 21 preadolescent children (avg. age 8.5 years) with type 1 diabetes, and compared that group to 15 healthy siblings. Investigators looked at flow-mediated dilatation (FMD), a gauge of the health of a major blood vessel of the upper arm artery, in both groups. FMD percentage (FMD%,) is a way to measure any stiffening of the blood vessels; stiffening blood vessels is an early precursor of cardiovascular disease.

Children who had high blood pressure, family history of high cholesterol or premature cardiovascular disease from other causes were excluded. Blood samples were collected from all participants to monitor cholesterol and sugar levels.

When tested, the blood vessels of children with type 1 diabetes had a lower FMD% change, which means their blood vessels were less expandable than the control group suggesting that higher circulating glucose results in increased rigidity of blood vessels independent of serum cholesterol levels. The patients with diabetes also had vascular inflammation, which is a known harbinger of future cardiovascular risk. Long-term studies are needed to evaluate the progression of those vascular changes through puberty and beyond.

The published paper, "Impaired Endothelial Function in Preadolescent Children with Type 1 Diabetes," was co-authored by Dr. Ghufran S. Babar, M.D., Children's Mercy Hospital, Kansas City, Missouri; Dr. Hanaa Zidan, M.D., Children's Hospital of Michigan, Detroit. .; Dr. Michael E. Widlansky, M.D., Medical College of Wisconsin.; Dr. Emon Das, M.D., Medical College of Wisconsin, Dr. Raymond G. Hoffman, PhD, Children's Research Institute of Children's Hospital of Wisconsin; and Dr. Marwan Daoud, Ph.D., Wayne State School of Medicine, Detroit.

About The Medical College of Wisconsin:

The Medical College of Wisconsin is the state's only private medical school and health sciences graduate school. Founded in 1893, it is dedicated to leadership and excellence in education, patient care, research and service. Approximately 1,200 students are enrolled in the Medical College's medical school and graduate school programs A major national research center, it is the largest research institution in the Milwaukee metro area and second largest in Wisconsin. In FY 2009 -10, faculty received approximately $161 million in external support for research, teaching, training and related purposes, of which $148 million is for research. This total includes highly competitive research and training awards from the National Institutes of Health (NIH). Annually, College faculty direct or collaborate on more than 2,000 research studies, including clinical trials. Additionally, more than 1,200 faculty physicians provide care in virtually every specialty of medicine to approximately 390,000 patients annually.

Maureen Mack | EurekAlert!
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