Key result
Young patients with diabetes had significantly higher levels of cytoadhesive molecules (sICAM-1 and sVCAM-1, p<0.001) and adiponectin (p<0.001) compared to healthy controls, reflecting subclinical inflammation and endothelial dysfunction.
Cross-Sectional (n=181)
Yes
Young patients with diabetes exhibit subclinical inflammation and endothelial dysfunction, which are further exacerbated by comorbid obesity and dyslipidemia.
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May signal early endothelial risk in young diabetes; leaves open prognostic value and intervention targets.
BACKGROUND: The impact of obesity and dyslipidemia on cardiovascular health in adolescents and young adults with diabetes is incompletely understood. This study evaluated the effects of these co-morbidities on markers of inflammation and endothelial dysfunction in young patients with the disease. METHODS: The study investigated sets of inflammatory, endothelial, and adipocyte biomarkers in 79 patients with type 1 diabetes, 55 patients with type 2 diabetes, and 47 controls. RESULTS: Mean (±SD) age was 20±6 y (median = 17, range = 12-31). Patients with diabetes had higher levels of cytoadhesive molecules (sICAM-1 and sVCAM-1, p<0.001), adiponectin (p<0.001), and haptoglobin (p = 0.023). Their heart rate variability assessment revealed lower standard deviation of beat-to-beat intervals and lower total power (p≤0.019), reflecting autonomous nervous dysfunction. Hemoglobin A1c >8.0% (estimated average blood glucose >10 mmol/L) was associated with higher adiponectin (p<0.001) and obesity was associated with lower adiponectin (p<0.001); thus, obesity damped the effect of hyperglycemia on adiponectin. Obesity was associated with higher sICAM-1 (p≤0.015), tumor necrosis factor-α (TNFα), interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP), p<0.001. Similarly, high-density lipoprotein (HDL) <1.02 mmol/L was associated with higher sICAM-1, TNFα, IL-6, and hsCRP (p≤0.009) and lower adiponectin (p<0.001). Adiponectin correlated negatively with the inflammatory biomarkers in patients with diabetes. CONCLUSION: Subclinical inflammation and endothelial dysfunction are common among young patients with diabetes. Poor diabetes control is associated with higher adiponectin. Obesity and dyslipidemia are associated with lower adiponectin and higher inflammatory and endothelial biomarkers. Intuitively, these predictors of cardiovascular disease are amenable to proper glycemic control, nutritional choices, and regular exercise.
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Aburawi et al. (2016) conducted a cross-sectional in Type 1 and Type 2 Diabetes Mellitus (n=181). Diabetes mellitus (Type 1 and Type 2) vs. Healthy non-diabetic controls was evaluated on Levels of cytoadhesive molecules (sICAM-1 and sVCAM-1) (p=<0.001). Young patients with diabetes had significantly higher levels of cytoadhesive molecules (sICAM-1 and sVCAM-1, p<0.001) and adiponectin (p<0.001) compared to healthy controls, reflecting subclinical inflammation and endothelial dysfunction.
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