TY - JOUR
TI - Carotid intima media thickness and associations with serum osteoprotegerin and s-RANKL in children and adolescents with type 1 diabetes mellitus with increased risk for endothelial dysfunction
AU - Karavanaki, K.
AU - Tsouvalas, E.
AU - Vakaki, M.
AU - Soldatou, A.
AU - Tsentidis, C.
AU - Kaparos, G.
AU - Augoulea, A.
AU - Alexandrou, A.
AU - Lambrinoudaki, I.
JO - Journal of Pediatric Endocrinology and Metabolism
PY - 2018
VL - 31
TODO - 11
SP - 1169-1177
PB - De Gruyter Mouton
SN - null
TODO - 10.1515/jpem-2018-0147
TODO - biological marker;  osteoclast differentiation factor;  osteoprotegerin, adolescent;  arterial wall thickness;  blood;  body mass;  child;  cross-sectional study;  diagnostic imaging;  echography;  female;  glucose blood level;  human;  insulin dependent diabetes mellitus;  male;  obesity;  pathophysiology;  vascular endothelium, Adolescent;  Biomarkers;  Blood Glucose;  Body Mass Index;  Carotid Intima-Media Thickness;  Child;  Cross-Sectional Studies;  Diabetes Mellitus, Type 1;  Endothelium, Vascular;  Female;  Humans;  Male;  Osteoprotegerin;  Overweight;  RANK Ligand;  Ultrasonography
TODO - Although carotid intima media thickness (CIMT) is an established marker of endothelial dysfunction, limited data exist on relative laboratory biomarkers in youngsters with type 1 diabetes mellitus (T1DM). Our aim was to study CIMT and the biomarkers of the osteoprotegerin (OPG)/RANKL system in young T1DM patients and controls, and also in subgroups of patients with increased risk for endothelial dysfunction, such as those with overweight/obesity, poor metabolic control or the presence of microalbuminuria. CIMT and OPG/RANKL of 56 T1DM children and adolescents were compared to 28 healthy controls. Anthropometric, laboratory, CIMT and OPG/RANKL measurements were similar between patients and controls. Overweight/obese patients had greater CIMT than the normal weight ones (0.50 vs. 0.44 mm, p=0.001). Microalbuminuric patients had greater CIMT (0.49 vs. 0.44 mm, p=0.035) than the normoalbuminuric ones, with no difference in terms of OPG/RANKL. In the microalbuminuric group, OPG (r=-0.90, p=0.036) and RANKL (r=-0.92, p=0.024) were significantly negatively associated with CIMT. Following linear regression analysis, in the total patients group, microalbuminuria was the only factor significantly associated with CIMT (beta±SE: 0.050±0.021, p=0.035), body mass index (BMI)-z-scores were negatively associated with OPG (beta±SE: -0.25±0.12, p=0.05), while in the microalbuminuric group, CIMT was negatively associated with OPG (beta±SE: -0.070±0.019, p=0.036). During the forward stepwise procedure, microalbuminuria and age were the only variables negatively associated with RANKL (b=-0.334, p=0.034, b=-35.95, p=0.013, respectively). In T1DM pediatric patients, overweight/obesity and microalbuminuria were associated with greater CIMT and with impaired OPG/RANKL levels, as biochemical indices of calcification of the atherosclerotic plaque. © 2018 2018 Walter de Gruyter GmbH, Berlin/Boston.
ER -