2081-P: Early Vascular Aging in Youth-Onset Type 2 Diabetes: Associations with Glucose and Insulin Responses in the Young at Heart Study

Introduction and Objective: Accelerated vascular aging is characteristic of youth-onset type 2 diabetes (Y-T2D), but mechanisms remain unclear. Insulin resistance (IR) may be an independent risk factor. We evaluated associations of arterial stiffness with fasting and whole-body IR. Methods: This is an interim analysis of a prospective study in 20 Y-T2D and 7 healthy peers who had a 75-g oral glucose tolerance test. IR was calculated as Matsuda Index and HOMA-IR. Arterial stiffness was measured after 12h fast as carotid-femoral pulse wave velocity (cfPWV) and augmentation index at heart rate 75 (AIx75). Associations were examined using age- and smoking-adjusted linear regression. Results: Participants were 20±3y (mean±SD), 56% female, BMI 35.7±11.7 kg/m2, HbA1c 6.6±2.4%. Y-T2D had higher BMI, HbA1c, and total fat mass (P<0.01). Mean cfPWV (6.2±0.2 m/s) did not differ by group and was not associated with glucose or IR markers (HOMA-IR (β=−0.005, P=0.83), Matsuda Index (β=−0.043, P=0.33), HbA1c (β=0.028, P=0.73), fasting glucose (β=0.0019, P=0.64)). cfPWV was associated with age (β=0.15 m/s, P<0.01), total fat mass (β=2.9×10-3, P<0.01), and BMI (β=0.03, P=0.09) and correlated with fat mass (Figure). Mean AIx75 was similar by group (18.4±1.8%) and was not associated with IR or glycemic markers. Conclusion: In youth, age was the strongest predictor of cfPWV. Fat mass, rather than glucose or insulin measures, may be a sensitive indicator of arterial stiffness.