scholarly journals Cardiovascular risk factors from diagnosis in children with type 1 diabetes mellitus: a longitudinal cohort study

2019 ◽  
Vol 7 (1) ◽  
pp. e000625 ◽  
Author(s):  
Stephanie Jones ◽  
Amal R Khanolkar ◽  
Evelien Gevers ◽  
Terence Stephenson ◽  
Rakesh Amin
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Density Lipoprotein ◽  
Diabetes Duration ◽  
Lipoprotein Cholesterol ◽  
Cvd Risk Factors ◽  
Cvd Risk

BackgroundFor childhood onset type 1 diabetes (T1D), the pathogenesis of atherosclerosis is greatly accelerated and results in early cardiovascular disease (CVD) and increased mortality. However, cardioprotective interventions in this age group are not routinely undertaken.AimsTo document prevalence of cardiovascular risk factors from diagnosis of childhood T1D and their relationship with disease duration and ethnicity.MethodsRoutinely collected clinical records for 565 children with T1D were retrospectively analyzed. Data were collected from diagnosis and at routine check-ups at pediatric diabetes clinics across Barts Health National Health Service Trust. Age at diagnosis was 8.5 years (0.9–19.4). Mean follow-up 4.3 years (0–10.8). 48% were boys and 60% were non-white. Linear longitudinal mixed effects models were used to evaluate relationships between risk factors and diabetes duration.ResultsCVD risk factors were present at first screening; 33.8% of children were overweight or obese, 20.5% were hypertensive (elevated diastolic blood pressure (BP)) and total cholesterol, low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol were abnormal in 63.5%, 34.2% and 22.0%, respectively. Significant associations between diabetes duration and annual increases of body mass index (0.6 kg/m2), BP (0.1 SD score) and lipids (0.02–0.06 mmol/L) were noted. Annual increases were significantly higher in black children for BP and Bangladeshi children for lipids. Bangladeshi children also had greatest baseline levels.ConclusionsCVD risk factors are present in up to 60% of children at diagnosis of T1D and increase in prevalence during the early years of the disease. Commencing screening in younger children and prioritizing appropriate advice and attention to ethnic variation when calculating risk should be considered.

Cardiovascular risk factors in children with type 1 diabetes mellitus

2019 ◽  
Vol 32 (7) ◽  
pp. 699-705 ◽  
Author(s):  
Ying Zhang ◽  
Han Zhang ◽  
Pin Li
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Type 1 Diabetes Mellitus ◽  
Cardiovascular Risk Factors ◽  
Density Lipoprotein ◽  
Diabetic Children

Abstract Objective Cardiovascular disease is a major complication among children with type 1 diabetes mellitus (T1DM). This prospective study aimed at examining the presence of cardiovascular risk factors in children with T1DM. Methods We evaluated several cardiovascular risk factors, including atherosclerosis, artery intima-media thickness (IMT) and metabolic responses, in 175 children with T1DM, with 150 non-diabetic children as normal controls. Results The diabetic children had significantly higher carotid IMT (cIMT) and aortic IMT (aIMT), higher values for diastolic wall stress (DWS), incremental elastic modulus (IEM), and flow-mediated dilatation (FMD) than the controls. The levels of tumor necrosis factor-α (TNF-α), interleukin-4 (IL4), high-sensitivity C-reactive protein (hs-CRP) and leptin were significantly higher in T1DM patients. In T1DM children, the cIMT and aIMT were correlated with several risk factors, including age, weight, body mass index (BMI), duration of diabetes, waist/hip ratio, as well as levels of total cholesterol, triglycerides and apolipoprotein B (apoB). In addition to common risk factors, cIMT was also associated with systolic blood pressure (BP). Other risk factors, such as height, diastolic BP, low-density lipoprotein (LDL)/high-density lipoprotein (HDL)-cholesterol ratio, apolipoprotein A1 (apoA1) and S-creatinine levels, were not all independent risk factors of cardiovascular disease in T1DM children. Conclusions T1DM is associated with early impairment of the common carotid and aortic artery structure and function, and the diabetic state may be the main risk factor for arterial wall stiffening and thickening.

scholarly journals Cardiovascular Health Benefits of Exercise Training in Persons Living with Type 1 Diabetes: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 253 ◽  
Author(s):  
Nana Wu ◽  
Shannon Bredin ◽  
Yanfei Guan ◽  
Kyra Dickinson ◽  
David Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Exercise Training ◽  
Cardiovascular Risk Factors ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Insulin Dosage

Exercise is advocated in the management of type 1 diabetes (T1D), but the effects of different forms of exercise training on cardiovascular risk factors in T1D still remain unclear. The aim of this study was to conduct a systematic review and meta-analysis on exercise training for cardiovascular risk factors in T1D. Six electronic databases were systematically searched for randomized or non-randomized controlled studies reporting associations between exercise training and cardiovascular risk factors in T1D. Weighted mean differences (WMD) of each cardiovascular risk factor between exercise groups and control groups were calculated using a random effects model. A total of 24 studies reported the effects of exercise training on cardiovascular risk factors. Exercise training increased maximal aerobic power (3.01 mL·kg−1·min−1, 95% confidence interval, CI, 0.94 to 6.38) and reduced glycated hemoglobin (HbA1c; −0.45%, 95% CI −0.73 to −0.17), daily insulin dosage (−0.88 U·kg−1, 95% CI −1.27 to −0.48), and total cholesterol (−0.38 mmol·L−1, 95% CI −0.71 to −0.04). Exercise training did not lead to consistent changes in body mass index (BMI), blood pressure, triglycerides, high-density lipoprotein cholesterol (HDL-C), or low-density lipoprotein cholesterol (LDL-C). In persons living with T1D, exercise training is associated with a beneficial cardiovascular profile, including improvements in lipid profile, glycemic control (decreased daily insulin dosage and HbA1c), and aerobic fitness.

scholarly journals Thirty year trends in cardiovascular risk factors prevalence among Siberian adolescents (1989-2019)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Denisova
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Risk Profile ◽  
Lipoprotein Cholesterol ◽  
Cvd Risk ◽  
Cross Sectional

Abstract Background Aim of the study was to assess trends of cardiovascular risk factors among Siberian adolescents during the last 30 years including period of Russian reforms (1989-2019). Methods Seven cross-sectional surveys of representative samples of school children aged 14-18 since 1989 (every 5 years) were carried out. Body mass index (BMI), systolic and diastolic blood pressure, serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured. Self-reported smoking and physical activity rates were obtained. To define overweight the sex- and age-specific IOTF cutoffs for BMI were used. Hypertension (HT) and lipid disorders were revealed according to international criteria. Results Prevalence of high TC significantly decreased from 22 to 4% (p < 0,01) in males and from 32 to 17% (p < 0,05) in females. High LDL-C showed similar trends. Prevalence of low HDL-C was stable with some fluctuations. In the period of Russian reforms (1989-1999) the prevalence of overweight significantly decreased from 12% in boys and from 14% in girls in 1989 to 4% in 1999 (p < 0,01). Since 2003 rapid increasing of overweight was observed. Trends of HT have shown double decreasing during the reform period and stabilization in the post-reform time. So, since 2003 discordant trends in HT and overweight were revealed. Physical activity was stably low in boys (49-55%) and girls (83-73%). Average weekly screen time doubled from 15 (2009) to 30 h/w (2019), p < 0,05. Cigarette smoking rates in boys dramatically decreased from 45% (1989) to 3% (2019), in girls - from 19% to 5% (p < 0,01). Smoking of electronic devices was registered in 2019: 6% among boys and 3% among girls. Conclusions Obtained data indicate on trends to reduction in CVD risk profile among Siberian adolescents during the period of Russian reforms. Discordant trends of HT and overweight were revealed. The study was supported by RFBR grant 19-013-00800. Key messages Long time changes in cardiovascular risk profile among Siberian adolescents were registered. Against the background of a decrease in combustible smoking among adolescents, electronic smoking began to register.

scholarly journals Impact of Fat Intake on Blood Glucose Control and Cardiovascular Risk Factors in Children and Adolescents with Type 1 Diabetes

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2625
Author(s):  
Chiara Garonzi ◽  
Gun Forsander ◽  
Claudio Maffeis
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Glycemic Control ◽  
Children And Adolescents ◽  
Cardiovascular Risk Factors ◽  
Specific Role ◽  
Fat Intake ◽  
High Fat

Nutrition therapy is a cornerstone of type 1 diabetes (T1D) management. Glycemic control is affected by diet composition, which can contribute to the development of diabetes complications. However, the specific role of macronutrients is still debated, particularly fat intake. This review aims at assessing the relationship between fat intake and glycemic control, cardiovascular risk factors, inflammation, and microbiota, in children and adolescents with T1D. High fat meals are followed by delayed and prolonged hyperglycemia and higher glycated hemoglobin A1c levels have been frequently reported in individuals with T1D consuming high amounts of fat. High fat intake has also been associated with increased cardiovascular risk, which is higher in people with diabetes than in healthy subjects. Finally, high fat meals lead to postprandial pro-inflammatory responses through different mechanisms, including gut microbiota modifications. Different fatty acids were proposed to have a specific role in metabolic regulation, however, further investigation is still necessary. In conclusion, available evidence suggests that a high fat intake should be avoided by children and adolescents with T1D, who should be encouraged to adhere to a healthy and balanced diet, as suggested by ISPAD and ADA recommendations. This nutritional choice might be beneficial for reducing cardiovascular risk and inflammation.

380-P: Endothelial Glycocalyx Dimensions and Cardiovascular Risk Factors in Type 1 Diabetes

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 380-P
Author(s):  
ELISABETH BUUR STOUGAARD ◽  
SIGNE WINTHER ◽  
HANAN AMADID ◽  
MARIE FRIMODT-MOELLER ◽  
FREDERIK PERSSON ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Endothelial Glycocalyx

scholarly journals 30-Year Cardiovascular Disease in Type 1 Diabetes: Risk and Risk Factors Differ by Long-Term Patterns of Glycemic Control

2021 ◽  
Author(s):  
Rachel G. Miller ◽  
Trevor J. Orchard ◽  
Tina Costacou
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Latent Class ◽  
Diabetes Duration ◽  
Cvd Risk ◽  
High Hba1c

<b>Objective:</b> We hypothesized that there is heterogeneity in long-term patterns of glycemic control with respect to cardiovascular disease (CVD) development in type 1 diabetes and that risk factors for CVD differ by glycemic control pattern. Thus, we estimated associations between data-derived latent HbA1c trajectories and 30-year CVD risk in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood-onset (<17 years old) type 1 diabetes.<b> </b> <p><b>Research Design and Methods: </b>Participants (n=536 with ≥2 HbA1c measurements [median 6] and CVD-free at baseline; mean age 27 and diabetes duration 18 years) were followed from 1986-88 to 2016-18 to ascertain CVD incidence (CVD death, myocardial infarction, stroke, coronary revascularization or blockage ≥50%, ischemic ECG, or angina). Latent HbA1c trajectories and their association with time-to-CVD incidence were simultaneously assessed using Joint Latent Class Mixed Models.</p> <p><b>Results:</b> Two HbA1c trajectories with respect to differential CVD risk were identified: Low (HbA1c ~8% [64 mmol/mol] and improving over follow-up, 76% of cohort) and High (HbA1c ~10% [86 mmol/mol] and stable, 24%). Overall, 30-year CVD incidence was 47.4% (n=253); MACE incidence 31.0% (n=176). High HbA1c was associated with 3-fold increased CVD risk versus Low HbA1c. Both groups had similar age and diabetes duration. Non-HDLc and estimated glomerular filtration rate were associated with CVD risk only in Low HbA1c; albumin excretion rate was associated with CVD risk only in High HbA1c.<b> </b></p> <p><b>Conclusions: </b>These risk factor differences suggest that pathways to CVD may differ by glycemic control, potentially resulting in important implications for prognosis in type 1 diabetes.</p>

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