Endothelial dysfunction related to the glycemic control as a very early vascular abnormality in young subjects with type 1 diabetes without complications.

Purpose: in type 1 diabetes (DM1) clinical complications are rare in childhood and adolescence, but preclinical vascular abnormalities may develop a few years after the onset of the disease. Aim of this study was to evaluate preclinical cardiovascular involvement in adolescents and young adults with early onset DM1, and its relation with glycemic control. Methods: 30 normotensive patients with DM1 free of macrovascular complications, microalbuminuria, retinopathy or neuropathy (mean age 19.3±3.1 years; BMI 22±3 kg/m2; disease duration: 11±5 years; HbA1c - average over the past four years in each patient - 7.9±1.4) and 14 controls of comparable age (mean age 20.4±3.2 years) and BMI (21.6±2.1kg/m2) were studied. Common carotid IMT was measured by B-mode ultrasound. The forearm peripheral reactive hyperemia index (RHI), a validated index of endothelial function, was assessed using EndoPAT system. Circulating EPC were analyzed for the expression of surface antigens anti-CD34 and anti-human kinase insert domain receptor (KDR). The frequency of peripheral blood cells positive for above reagents was determinated by flow cytometry. Validation of the assay was performed by the ISHAGE method. Left ventricular (LV) geometry and function were assessed by Doppler-echocardiography. Results: Compared to controls, DM1 patients, although normotensive, had significantly higher diastolic BP (68±7 vs 62±5mmHg, ......