Abstract

Assessment of Subclinical Cardiovascular Abnormalities in Type 1 Diabetic Children with Normal LDL Levels

Author(s):Reham M. Wagdy, Ahmed Abu Gabel, Omar F. El Azzouni and Rasha Abdel Munem

Background: Children with type 1 diabetes mellitus (T1DM) are at risk for accelerated atherosclerotic changes and cardiac abnormalities rather than non-diabetics. However, little is known about cardiovascular changes for diabetic children with normal low-density lipoprotein. Here, we assessed atherosclerotic changes and cardiac function by sonography for patients with normal low-density lipoprotein. Methods: A prospective case control study included 38 type 1 Diabetes Mellitus children (aged 8 to 14 years) was performed with same number of matched children as controls. Blood pressure, body mass indices (BMI), glycosylated haemoglobin (HbA1c), complete lipid profile, intimal medial wall thickness measurements for carotid arteries (cIMT) and abdominal aorta (aIMT) with data of left ventricular function by echocardiography were determined for both groups. Results: We found aIMT (mean of 1.2 ± 0.4) and cIMT (mean of 0.52 ± 0.12) were significantly higher in the patient group (P<0.001). Although, aIMT was positively correlated to HbA1c (7.48 ± 0.76%, P<0.001) and negatively correlated to high density lipoprotein, no significant difference between aIMT or cIMT and age, duration of disease, BMI, and blood pressure. Moreover, no significant difference in LV systolic or diastolic function among the studied groups, however the Z score of end systolic dimensions and end diastolic dimensions were significantly changed for patient group ((P=0.012 and P=0.008 respectively). Conclusion: Subclinical atherosclerosis was detected among T1DM children with normal LDL and it was positively correlated to prolonged hyperglycemia and low level of HDL. However, subclinical cardiac function changes were minimal.

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