Altered endothelial function in asymptomatic male adolescents with type 1 diabetes

Objective. While adult men and women with diabetes experience similar rates of cardiovascular disease, early microvascular complications show significant gender differences during adolescence. The goal of this study was to determine whether a gender contrast in a preclinical stage of atherosclerosis, or endothelial dysfunction, is present in pediatric diabetic patients. Methods. Reactive hyperemia-peripheral arterial tonometry (RH-PAT), a noninvasive method to assess endothelial dysfunction, was used. Measurements were performed at rest and after hyperemia in 20 diabetic subjects and 20 age- and gender-matched nondiabetics, aged 12-16 years. Confounding risk factors for endothelial dysfunction, including smoking, obesity, and hypertension, were excluded. Results. RH-PAT was lower for male diabetic subjects vs. controls (n=12, 1.60±0.32 vs. 1.92±0.28, P <.001). RH-PAT was similar in female diabetic patients vs. controls. Male and females with type 1 diabetes subjects had equivalent metabolic control (HbA1C 7.48±1.0 vs.7.51±0.9) and lipid profiles. No difference was observed in age, HbA1C, and diabetes duration, between male and female diabetic subjects. However, diabetic female patients had a greater body mass index (24.2±2.5 vs. 20.6±2.0, P=.003) and were more mature in pubertal status as compared with diabetic male patients. Conclusion. Endothelial dysfunction was present in adolescent male diabetic subjects as measured using RH-PAT. Considering that endothelial dysfunction is reversible, early detection of this process may have theurapeutic and prognostic implications in this young age group.