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Acta Diabetol. 2018 Jan;55(1):41-47. doi: 10.1007/s00592-017-1063-1. Epub 2017 Oct 24.

HLA, infections and inflammation in early stages of atherosclerosis in children with type 1 diabetes.

Author information

1
Department of Paediatric Cardiology, Paediatric Heart Center, Lund University and Skåne University Hospital, 22185, Lund, Sweden.
2
Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
3
Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
4
Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden.
5
Department of Paediatric Cardiology, Paediatric Heart Center, Lund University and Skåne University Hospital, 22185, Lund, Sweden. petru.liuba@med.lu.se.

Abstract

AIMS:

This prospective study focuses on risk factors for arterial damage in children with type 1 diabetes (T1D).

METHODS:

Eighty children and adolescents with T1D were investigated twice, approximately 2 years apart, for carotid artery intima-media thickness (cIMT) and compliance (CAC), flow-mediated dilatation (FMD) of the brachial artery, and plasma levels of matrix metalloproteinase (MMP)-8. All subjects were genotyped for HLA. The number of respiratory tract infections (RTI) during the past year was obtained by a questionnaire in 56 patients.

RESULTS:

cIMT progression, defined as percentage (%) change of cIMT from baseline, correlated inversely with the % changes of both CAC (p = 0.04, r = - 0.3; n = 62) and FMD (p = 0.03, r = - 0.3; n = 47). In multivariate analysis, RTI frequency correlated significantly with cIMT progression irrespective of age, diabetes duration, BMI, and HbA1c (p = 0.03, r = 0.3). When patients were divided in relation to RTI, the association of DQ2/8 with cIMT progression remained significant in patients with over three infections/year (p = 0.04, r = 0.3). During follow-up, the group of DQ2/8 patients with hsCRP > 1 mg/l showed significantly higher levels of plasma MMP-8 than the non-DQ2/8 group.

CONCLUSIONS:

The diabetes-risk genotype DQ2/8 and systemic inflammation contribute to pro-atherosclerotic vascular changes in children and adolescents with T1D.

KEYWORDS:

Children; Infections; Intima-media thickness; Matrix metalloproteinase-8; Type 1 diabetes

PMID:
29064046
PMCID:
PMC5794827
DOI:
10.1007/s00592-017-1063-1
[Indexed for MEDLINE]
Free PMC Article

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