Young patients with type 1 diabetes mellitus exhibited significant early cardiovascular remodeling, including increased epicardial adipose tissue thickness and lower cardioprotective miR-126-5p levels compared to healthy controls.
Cross-Sectional (n=40)
No
Are there early structural, functional, and epigenetic markers of cardiovascular pathology in young patients with type 1 diabetes mellitus without clinical cardiovascular disease?
Young patients with type 1 diabetes mellitus exhibit early subclinical signs of cardiovascular remodeling, including increased epicardial adipose tissue, myocardial fibrosis, and altered adipokine and miRNA profiles.
Absolute Event Rate: 0.6% vs 0.4%
p-value: p=0.001
Cardiovascular disease (CVD) in type 1 diabetes mellitus (T1DM) is preceded by asymptomatic changes in the geometry of the heart. The only symptoms of the beginning of cardiac remodeling and concomitant predictors of an unfavorable cardiovascular prognosis are: thickening of epicardial fat (EAT), secreting a number of adipokines, and cardiospecific miRNAs. To improve the effectiveness of prevention of CVD in young patients with DM1, a search was made for structural-functional and epigenetic markers. Aim. To assess the state of the cardiovascular system according to MRI-heart with T1 mapping in T1DM without CVD. To reveal the relationship of epigenetic markers (circulating miR-126-5p, miR-21-5p) and adipokines with cardiovascular system in T1DM. Suggested personalized approach to patients with T1DM with initial manifestations of joint remodeling and/or exclusion of cardiospecific microRNA. Materials and methods. The study included 40 patients: 30 with T1DM (age 26.2±7.4 years), 10 without T1DM (26.4±8.2). The patients underwent a general clinical examination, bioimpedancemetry, electrocardiography, MRI of the heart with T1 mapping, determination of adiponectin, resistin, visfatin, NT-proBNP, miR-126-5p, miR-21-5p. Results. Patients with T1DM had lower levels of cardioprotective miR-126-5p (p=0.046). According to MRI of the heart in T1DM, signs of vascular remodeling were revealed – thickening of the interventricular septum (p=0.001), posterior wall (p=0.012) and relative size of the walls (p=0.048) of the left ventricle, an increase in EAT density (p=0.001). Diffuse vascular fibrosis was found in 16% of patients from the T1DM group. Also, in T1DM, the expression of visfatin is increased (p=0.036) and adiponectin is reduced (p=0.043). Conclusion. Structural and functional changes in the cardiovascular system (including thickening of the EAT), shifts in miR-126-5p expression and adipokines profile are observed already at a young age in patients with T1DM. In T1DM, diffuse vascular fibrosis is detected in 16% of patients. The data obtained were used to identify the group increased risk of developing CVD in T1DM and served as the basis for determining the timing of the start of preventive therapy.
Vengrzhinovskaya et al. (Thu,) conducted a cross-sectional in Type 1 diabetes mellitus (n=40). Type 1 diabetes mellitus vs. Healthy controls without diabetes was evaluated on Epicardial adipose tissue (EAT) thickness in cm (median) (p=0.001). Young patients with type 1 diabetes mellitus exhibited significant early cardiovascular remodeling, including increased epicardial adipose tissue thickness and lower cardioprotective miR-126-5p levels compared to healthy controls.