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Advanced glycation end products in children with type 1 diabetes and early reduced diastolic heart function.
BMC Cardiovasc Disord. 2017 05 25; 17(1):133.BC

Abstract

BACKGROUND

Reduced diastolic function is an early sign of diabetes cardiomyopathy in adults and is associated with elevated levels of HbA1c and advanced glycation end products (AGEs).

OBJECTIVE

To assess the associations between early reduced diastolic function and elevated levels of HbA1c and AGEs in children and adolescents with type 1 diabetes (T1D).

METHODS

One hundred fourty six T1D patients (age 8-18 years) without known diabetic complications were examined with tissue Doppler imaging and stratified into two groups according to diastolic function. A clinical examination and ultrasound of the common carotid arteries were performed. Methylglyoxal-derived hydroimidazolone-1 (MG-H1) was measured by immunoassay.

RESULTS

At inclusion, 36 (25%) participants were stratified into a low diastolic function group (E'/A'-ratio < 2.0). Compared to the rest of the T1D children, these participants had higher body mass index (BMI), 22.8 (SD = 4.0) vs. 20.1 (SD = 3.4) kg/m2, p < 0.001, higher systolic blood pressure 104.2 (SD = 8.7) vs. 99.7 (SD = 9.3) mmHg, p = 0.010, and higher diastolic blood pressure, 63.6 (SD = 8.3) vs. 59.9 (SD = 7.9) mmHg, p = 0.016. The distensibility coefficient was lower, 0.035 (SD = 0.010) vs. 0.042 (SD = 0.02) kPa-1, p = 0.013, Young's modulus higher, 429 (SD = 106) vs. 365 (SD = 143), p = 0.009, and MG-H1 higher, 163.9 (SD = 39.2) vs. 150.3 (SD = 33.4) U/ml, p = 0.046. There was no difference in carotid intima-media thickness between the groups. There were no associations between reduced diastolic function and years from diagnosis, HBA1c, mean HBA1c, CRP or calculated glycemic burden. Logistic regression analysis showed that BMI was an independent risk factor for E'/A'-ratio as well as a non-significant, but relatively large effect size for MG-H1, indicating a possible role for AGEs.

CONCLUSIONS

Early signs of reduced diastolic function in children and adolescents with T1D had higher BMI, but not higher HbA1c. They also had elevated serum levels of the advanced glycation end product MG-H1, higher blood pressure and increased stiffness of the common carotid artery, but these associations did not reach statistical significance when tested in a logistic regression model.

Authors+Show Affiliations

Department of Pediatrics, Oslo University Hospital, Oslo, Norway. leifbrunvand@hotmail.com.Department of Pediatrics, Oslo University Hospital, Oslo, Norway. Oslo Diabetes Research Centre, Oslo, Norway. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.Oslo Diabetes Research Centre, Oslo, Norway. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.Department of Neonatal Intensive Care, Oslo University Hospital, Ullevål, Oslo, Norway. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.Department of Radiology and Nuclear Medicine, St. Olavs Hospital, and Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.Department of Pediatrics, Oslo University Hospital, Oslo, Norway. Oslo Diabetes Research Centre, Oslo, Norway. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.Oslo Diabetes Research Centre, Oslo, Norway. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. The Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28545398

Citation

Brunvand, Leif, et al. "Advanced Glycation End Products in Children With Type 1 Diabetes and Early Reduced Diastolic Heart Function." BMC Cardiovascular Disorders, vol. 17, no. 1, 2017, p. 133.
Brunvand L, Heier M, Brunborg C, et al. Advanced glycation end products in children with type 1 diabetes and early reduced diastolic heart function. BMC Cardiovasc Disord. 2017;17(1):133.
Brunvand, L., Heier, M., Brunborg, C., Hanssen, K. F., Fugelseth, D., Stensaeth, K. H., Dahl-Jørgensen, K., & Margeirsdottir, H. D. (2017). Advanced glycation end products in children with type 1 diabetes and early reduced diastolic heart function. BMC Cardiovascular Disorders, 17(1), 133. https://doi.org/10.1186/s12872-017-0551-0
Brunvand L, et al. Advanced Glycation End Products in Children With Type 1 Diabetes and Early Reduced Diastolic Heart Function. BMC Cardiovasc Disord. 2017 05 25;17(1):133. PubMed PMID: 28545398.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advanced glycation end products in children with type 1 diabetes and early reduced diastolic heart function. AU - Brunvand,Leif, AU - Heier,Martin, AU - Brunborg,Cathrine, AU - Hanssen,Kristian F, AU - Fugelseth,Drude, AU - Stensaeth,Knut Haakon, AU - Dahl-Jørgensen,Knut, AU - Margeirsdottir,Hanna Dis, Y1 - 2017/05/25/ PY - 2017/01/21/received PY - 2017/05/02/accepted PY - 2017/5/27/entrez PY - 2017/5/27/pubmed PY - 2018/1/9/medline SP - 133 EP - 133 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 17 IS - 1 N2 - BACKGROUND: Reduced diastolic function is an early sign of diabetes cardiomyopathy in adults and is associated with elevated levels of HbA1c and advanced glycation end products (AGEs). OBJECTIVE: To assess the associations between early reduced diastolic function and elevated levels of HbA1c and AGEs in children and adolescents with type 1 diabetes (T1D). METHODS: One hundred fourty six T1D patients (age 8-18 years) without known diabetic complications were examined with tissue Doppler imaging and stratified into two groups according to diastolic function. A clinical examination and ultrasound of the common carotid arteries were performed. Methylglyoxal-derived hydroimidazolone-1 (MG-H1) was measured by immunoassay. RESULTS: At inclusion, 36 (25%) participants were stratified into a low diastolic function group (E'/A'-ratio < 2.0). Compared to the rest of the T1D children, these participants had higher body mass index (BMI), 22.8 (SD = 4.0) vs. 20.1 (SD = 3.4) kg/m2, p < 0.001, higher systolic blood pressure 104.2 (SD = 8.7) vs. 99.7 (SD = 9.3) mmHg, p = 0.010, and higher diastolic blood pressure, 63.6 (SD = 8.3) vs. 59.9 (SD = 7.9) mmHg, p = 0.016. The distensibility coefficient was lower, 0.035 (SD = 0.010) vs. 0.042 (SD = 0.02) kPa-1, p = 0.013, Young's modulus higher, 429 (SD = 106) vs. 365 (SD = 143), p = 0.009, and MG-H1 higher, 163.9 (SD = 39.2) vs. 150.3 (SD = 33.4) U/ml, p = 0.046. There was no difference in carotid intima-media thickness between the groups. There were no associations between reduced diastolic function and years from diagnosis, HBA1c, mean HBA1c, CRP or calculated glycemic burden. Logistic regression analysis showed that BMI was an independent risk factor for E'/A'-ratio as well as a non-significant, but relatively large effect size for MG-H1, indicating a possible role for AGEs. CONCLUSIONS: Early signs of reduced diastolic function in children and adolescents with T1D had higher BMI, but not higher HbA1c. They also had elevated serum levels of the advanced glycation end product MG-H1, higher blood pressure and increased stiffness of the common carotid artery, but these associations did not reach statistical significance when tested in a logistic regression model. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/28545398/Advanced_glycation_end_products_in_children_with_type_1_diabetes_and_early_reduced_diastolic_heart_function_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-017-0551-0 DB - PRIME DP - Unbound Medicine ER -