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. 2011 May;96(5):1493-9.
doi: 10.1210/jc.2010-2363. Epub 2011 Feb 23.

Endothelial dysfunction is related to poor glycemic control in adolescents with type 1 diabetes under 5 years of disease: evidence of metabolic memory

Gislaine Vissoky Cé  1 , Luis Eduardo Rohde, Antônio Marcos Vargas da Silva, Márcia Khaled Puñales, Andrea Cauduro de Castro, Marcello Casaccia Bertoluci
Affiliations

Endothelial dysfunction is related to poor glycemic control in adolescents with type 1 diabetes under 5 years of disease: evidence of metabolic memory

Gislaine Vissoky Cé et al. J Clin Endocrinol Metab. 2011 May.

Erratum in

  • J Clin Endocrinol Metab. 2011 Jun 1;96(6):1908. Coutinho, Márcia Khaled Puñales [corrected to Puñales, Márcia Khaled]

Abstract

Context: The relation between endothelial dysfunction (ED), glycemic control, and early type I diabetes mellitus (T1DM) is unclear.

Objective: The objective of the study was to evaluate the association of ED, glycemic control, and the duration of diabetes in T1DM.

Design: This was a cross-sectional study.

Setting: The study was conducted at a public outpatient clinic.

Patients: Fifty-seven T1DM adolescents and 10 healthy age-matched controls participated in the study.

Intervention: There were no interventions.

Methods and outcome measures: Endothelial function (ED) was evaluated by flow-mediated dilation (FMD) in the brachial artery after reactive hyperemia. Biochemical data, including HbA1c (glycohemoglobin), high-sensitivity C-reactive protein, lipids, and urinary albumin excretion were collected. Means of four HbA1c values collected at 3-month intervals in the first and second year before FMD analyses were obtained.

Results: Mean FMD was decreased in T1DM compared with controls (P = 0.023), independent of age, smoking, hypertension, or dyslipidemia. Twenty-eight of 57 T1DM patients enrolled (49%) had ED. FMD was decreased in microalbuminuric (4.1%) compared with normoalbuminuric patients (10.1%, P = 0.01) and controls (14.6%, P < 0.001). FMD correlated inversely with mean second-year HbA1c (r = -0.426, P = 0.02), particularly in patients with less than 5 yr of T1DM (r = -0.61, P = 0.004). In these patients, high-sensitivity C-reactive protein was strongly correlated with mean first-year HbA1c (r = -0.66, P = 0.0003). In patients with more than 5 yr of T1DM, we found no significant correlations between ED and glycemic control.

Conclusions: Endothelial dysfunction is common in T1DM adolescents with less than 5 yr of disease. It is associated with duration of disease, microalbuminuria, and mean second-year HbA1c but not with mean first-year HbA1c. These data support the metabolic memory hypothesis.

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