Glycemic Control Could Reverse Subclinical Atherosclerotic Changes and Normal Adiponectin Levels in Lean Type-1 Diabetic Children

[摘要] Adiponectin is an anti-inflammatory, antiatherogenic, and insulin-sensitizing hormone. It inhibits neointimal media thickening and vascularsmooth muscle cell proliferation. This study aimed at delineating the relation between glycemic control and adiponectin levels and its impact oncarotid intima media thickness (cIMT) in lean, newly diagnosed type-1 diabetic children. 46 diabetic children were examined, their mean agewas 11.59 ± 3.64 years (mean duration of diabetes 2.89 ± 1.15 years, mean BMI 20.86 ± 3.94, mean annual HbA1c 7.7 ± 1.5). 46healthy control subjects matched in age, sex, and BMI were enrolled in this cross-sectional study at the Suez Canal University Hospital pediatricoutpatient clinic in Ismailia. All children had normal blood pressure for age and sex, normal lipid profile and normomalbuminuria. Adiponectinand HbA1c were measured, carotid intima media thickness was assessed. Adiponectin levels were significantly lower in children with type-1diabetes mellitus (DM1; 10.1 ± 1.57 mg) compared with controls (11.23 ± 1.14 mg; p = 0.02). Children with DM1 had a significantlyhigher cIMT (0.55 ± 0.06 mm) than controls (0.43 ± 0.04 mm; p = 0.00). Adiponectin levels correlated negatively with cIMT (p = 0.01).Adiponectin levels showed no significant difference in children with good metabolic control (average annual HBA1c < 7 %; 11.51 ± 0.45 mg)compared to the control group (11.23 ± 1.14 mg; p = 0.15). Adiponectin was significantly higher (11.51 ± 0.45 mg) and cIMT was significantlylower (0.45 ± 0.03 mm) in children with good metabolic control than in those with poor metabolic control (9.43 ± 1.38 mg; 0.57 ± 0.05 mm).From the results it can be concluded that glycemic control may have a crucial impact on preventing atherosclerotic changes in type-1 diabeticchildren with a short duration of diabetes. Diabetic children with good metabolic control and a short duration of diabetes had no significantdifference in adiponectin levels compared to healthy children.

[学科分类] 心脏病和心血管学

[关键词] adiponectin;carotid intima media thickness;glycemic control;glydemic control;subclinical atherosclerosis;type-1 diabetes