Evaluation of cardiovascular disease risk in children with type 1 diabetes mellitus by oscillometric method and echocardiography

Objective: Type 1 diabetes mellitus (T1DM) patients have an increased risk of developing cardiovascular disease. Our study aimed to compare epicardial fat thickness (EFT), carotid intima‐media thickness (cIMT), and arterial stiffness parameters such as pulse wave velocity (PWV), augmentation index (AI), which are well-known early markers of cardiovascular disease in adults, between children with T1DM and healthy individuals. Methods: One hundred fifteen children with T1DM and 87 age, gender, and anthropometric measurements-matched healthy children were included. The inclusion criteria for patients were having T1DM for at least 2 years and ages 8–18 years. Epicardial fat thickness and cIMT were assessed by the same pediatric cardiologist. Noninvasively, the Mobil-O-Graph® was used to evaluate PWV, AI (normalized to a heart rate of 75 beats/sec: AI@75), and the hemodynamic parameters. Results: Epicardial fat thickness and cIMT were higher (p<0.001), stroke volume and cardiac index scores were found significantly lower (p<0.001 and p=0.030, respectively) in the patient group compared with the control group. While the AI@75 was significantly higher in the patient group (p <0.01), PWV did not differ between groups (p=0.782). According to the glycated hemoglobin A1c (HbA1c) level, EFT (p=0.015) was significantly higher, and cardiac index score (p=0.030) was significantly lower in the HbA1c >9% group. A strong positive correlation was detected between mean cIMT and microalbuminuria (Rho=,925, p<0.01). Conclusion: These results support that children with T1DM present significant changes in important subclinical indicators for showing the development of cardiovascular disease. Cardiologic assessment of patients with T1DM can be beneficial for long-term care.