Endothelial Dysfunction and Diabetes Related Complications in Adolescents with Type 1 Diabetes
Authors:   Department of Paediatric Endocrinology and Diabetes, Children’s Health Ireland, Tallaght, Dublin, Ireland. Discipline of Paediatrics, Trinity College, The University of Dublin, & Children’s Health Ireland at Tallaght, Dublin, Ireland, Dublin, Ireland, N Metwally , AP Macken ,   Department of Paediatrics, South Tipperary General Hospital, Clonmel, Co Tipperary, Ireland. National Children’s Research Centre, Children’s Health Ireland, Crumlin, Dublin, Ireland, C McDonnell ,   Department of Paediatric Endocrinology and Diabetes, Children’s Health Ireland, Tallaght, Dublin, Ireland. Discipline of Paediatrics, Trinity College, The University of Dublin, & Children’s Health Ireland at Tallaght, Dublin, Ireland, Dublin, Ireland, CS O’Gorman ,   Department of Paediatrics, School of Medicine, University of Limerick, Limerick, Ireland. Department of Paediatrics, University Hospital Limerick, Limerick, Ireland. National Children’s Research Centre, Children’s Health Ireland, Crumlin, Dublin, Ireland, EJ Molloy ,   Discipline of Paediatrics, Trinity College, The University of Dublin, & Children’s Health Ireland at Tallaght, Dublin, Ireland, Dublin, Ireland. Trinity Research in Childhood Centre (TRiCC), & Trinity Translational Medicine Institute (TTMI), Trinity College Dublin, Ireland. Department of Neonatology, Coombe Women and Infants University Hospital, Dublin, Ireland. Department of Neonatology, Children’s Health Ireland at Crumlin, Dublin, Ireland, EF Roche ,   Department of Paediatric Endocrinology and Diabetes, Children’s Health Ireland, Tallaght, Dublin, Ireland. Discipline of Paediatrics, Trinity College, The University of Dublin, & Children’s Health Ireland at Tallaght, Dublin, Ireland, Dublin, Ireland
Published: January 2022

Introduction: Patients with Type 1 Diabetes (T1D) are at high risk of developing vascular complications. Endothelial Dysfunction (ED) is the early reversible stage of vascular disease. Aim: Poor Diabetic control is associated with ED. Based on a hypothesis we aimed to determine the relationship between metabolic control and endothelial function in a cohort of adolescents with T1D. Methods: 42 adolescents with T1D were recruited. Weights, heights and BMI were recorded. Blood pressure was measured, followed by assessment of Reactive hyperaemia index (RHI) by Endo-PAT. Fasting blood samples were taken for evaluation of HbA1c, liver, renal function, lipid profile. Inflammatory markers (adiponectin, leptin, thrombomodulin, serum Intravascular Adhesion Molecules (sICAM), E-Selectin and p-Selectin) were measured in 20 patients. Urinary microalbumin to creatinine ratio measured. Participants completed a physical activity questionnaire. Baseline data included the date of diagnosis, duration of diabetes, current insulin dose, insulin regimen, daily screen time and relevant family history of early cardiovascular disease. Results: Reactive hyperaemia index correlated with age. Thirteen adolescents (31%) had low RHI, suggesting relatively impaired endothelial function. Lower RHI correlated with higher diastolic blood pressure (r=-0.34) and p-Selectin level (r=-0.3) suggesting impairment in vascular health. Poor metabolic control was associated with impaired lipid profile (r=0.55), higher diastolic blood pressure (r=0.38) and higher level of inflammatory markers Pselectin (r=0.55). Active life style was associated with improved blood pressure (r=-0.35) and lipid profile (r=-0.39).