Ambulatory blood pressure and carotid intima media thickness in children with type 1 diabetes
Ambulatory blood pressure and carotid intima media thickness in children with type 1 diabetes
Background/Objective: Blood pressure abnormalities may play an important role in macrovascular damage in type 1 diabetes. Little is known about blood pressure abnormalities and macrovascular damage in children with type 1 diabetes. Methods: Children with type 1 diabetes (n = 57) for a short (3 months-2 years; n = 24) or long duration (≥5 years; n = 33) and a group of control children without diabetes (n = 29) completed 24-h ambulatory blood pressure monitoring (ABPM). Carotid intima media thickness (cIMT), a subclinical indicator of atherosclerosis, was assessed by carotid ultrasound. Results: ABPM abnormalities were more prevalent (57% vs 24%, respectively), and daytime, nighttime and 24-h systolic, diastolic, and mean arterial blood pressure indices were higher in children with type 1 diabetes compared to control children. The odds estimate of an ABPM abnormality was 6.68 (95% confidence interval: 1.95, 22.9; P =.003) in children with type 1 diabetes compared to controls after adjusting for age, sex, and BMI standardized for age and sex (zBMI). An interaction between ABPM and zBMI on cIMT was observed. In children with type 1 diabetes and ABPM abnormalities, every 1 SD increase in zBMI was associated with a 0.030 mm increase in cIMT (95% confidence interval: 0.002, 0.041; P =.031). This was not observed in control children with ABPM abnormalities or in children with normal ABPM, regardless of type 1 diabetes status. Conclusions: Children with type 1 diabetes have a high prevalence of ABPM abnormalities independent of disease duration and this is related to early indicators of cardiovascular damage.
ambulatory blood pressure monitoring, BMI, carotid-intima media thickness, children, type 1 diabetes
358-365
Glackin, Sinead
c3b44561-adea-4642-a08c-0e1e3bf13c7a
Islam, Nazrul
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Henderson, Amanda M.
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Dionne, Janis M.
70c182ce-8d1c-4653-912d-86745e9769fa
Harris, Kevin C.
ac47513a-a0f6-4d3f-8985-6a487a35223a
Panagiotopoulos, Constadina
72de7825-15ff-43c6-b423-8a09e2181291
Devlin, Angela M.
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5 February 2020
Glackin, Sinead
c3b44561-adea-4642-a08c-0e1e3bf13c7a
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Henderson, Amanda M.
d9b832f5-be97-4c27-a12f-b560c2df0a64
Dionne, Janis M.
70c182ce-8d1c-4653-912d-86745e9769fa
Harris, Kevin C.
ac47513a-a0f6-4d3f-8985-6a487a35223a
Panagiotopoulos, Constadina
72de7825-15ff-43c6-b423-8a09e2181291
Devlin, Angela M.
9b2302f9-76d9-484d-9951-98c78694b272
Glackin, Sinead, Islam, Nazrul, Henderson, Amanda M., Dionne, Janis M., Harris, Kevin C., Panagiotopoulos, Constadina and Devlin, Angela M.
(2020)
Ambulatory blood pressure and carotid intima media thickness in children with type 1 diabetes.
Pediatric Diabetes, 21 (2), .
(doi:10.1111/pedi.12960).
Abstract
Background/Objective: Blood pressure abnormalities may play an important role in macrovascular damage in type 1 diabetes. Little is known about blood pressure abnormalities and macrovascular damage in children with type 1 diabetes. Methods: Children with type 1 diabetes (n = 57) for a short (3 months-2 years; n = 24) or long duration (≥5 years; n = 33) and a group of control children without diabetes (n = 29) completed 24-h ambulatory blood pressure monitoring (ABPM). Carotid intima media thickness (cIMT), a subclinical indicator of atherosclerosis, was assessed by carotid ultrasound. Results: ABPM abnormalities were more prevalent (57% vs 24%, respectively), and daytime, nighttime and 24-h systolic, diastolic, and mean arterial blood pressure indices were higher in children with type 1 diabetes compared to control children. The odds estimate of an ABPM abnormality was 6.68 (95% confidence interval: 1.95, 22.9; P =.003) in children with type 1 diabetes compared to controls after adjusting for age, sex, and BMI standardized for age and sex (zBMI). An interaction between ABPM and zBMI on cIMT was observed. In children with type 1 diabetes and ABPM abnormalities, every 1 SD increase in zBMI was associated with a 0.030 mm increase in cIMT (95% confidence interval: 0.002, 0.041; P =.031). This was not observed in control children with ABPM abnormalities or in children with normal ABPM, regardless of type 1 diabetes status. Conclusions: Children with type 1 diabetes have a high prevalence of ABPM abnormalities independent of disease duration and this is related to early indicators of cardiovascular damage.
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e-pub ahead of print date: 11 December 2019
Published date: 5 February 2020
Additional Information:
Funding Information:
This study was supported by funding from the Canucks for Kids Fund. A.M.D. is supported by an Investigator Grant from BC Children's Hospital Research Institute. We thank Ben Mammon for assistance with the recruitment of participants for this project. We sincerely thank to all participants.
Publisher Copyright:
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Keywords:
ambulatory blood pressure monitoring, BMI, carotid-intima media thickness, children, type 1 diabetes
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Local EPrints ID: 471721
URI: http://eprints.soton.ac.uk/id/eprint/471721
ISSN: 1399-543X
PURE UUID: c95965c3-ec2a-40a8-93a5-62ff3de1dad8
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Date deposited: 17 Nov 2022 17:32
Last modified: 18 Mar 2024 04:07
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Contributors
Author:
Sinead Glackin
Author:
Nazrul Islam
Author:
Amanda M. Henderson
Author:
Janis M. Dionne
Author:
Kevin C. Harris
Author:
Constadina Panagiotopoulos
Author:
Angela M. Devlin
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