Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes

Michael J. Haller, Jennifer Stein, Jon Shuster, Douglas Theriaque, Janet Silverstein, Desmond A. Schatz, Michael G. Earing, Amir Lerman, Farid H. Mahmud

Research output: Contribution to journalArticle

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Abstract

Objectives: To assess the ability of reactive hyperemia-peripheral artery tonometry (RH-PAT) to serve as a surrogate marker of endothelial dysfunction in children with type 1 diabetes (T1D). Research Design and Methods: Forty-four children with T1D [age 14.6 ± 2.7 yr; duration of diabetes 6.01 ± 4 yr; range of diabetes duration 1-16 yr; and hemoglobin A1c (HbA1c) 8.34 ± 1.2%] and 20 children without diabetes (age 14.1 ± 1.5 yr) underwent RH-PAT endothelial function testing after an overnight fast. Height, weight, body mass index (BMI), blood pressure (BP), fasting lipid profile, and glucose level were determined in each child. Children with T1D underwent a second RH-PAT study 4 wk after their initial study to determine the intrapatient variability of the technique. Results: Children with T1D had endothelial dysfunction as evidenced by lower mean RH-PAT scores (1.63 ± 0.5) when compared with children without diabetes (mean RH-PAT score 1.95 ± 0.3) (p = 0.01). Repeat RH-PAT scores were predicted by initial RH-PAT scores (p = 0.0025). Mean intrapatient standard deviation of RH-PAT score was 0.261 and mean coefficient of variation was 14.8. Variations in RH-PAT score were not explained by differences in glucose, HbA1c, BMI, systolic BP, diastolic BP, or lipids. Conclusions: Although larger validation studies are required, RH-PAT is a promising non-invasive technique to assess endothelial function in children with T1D. Non-invasive measures of endothelial dysfunction may provide the additional risk stratification data needed to justify more aggressive primary prevention of cardiovascular disease in children with T1D.

Original languageEnglish (US)
Pages (from-to)193-198
Number of pages6
JournalPediatric Diabetes
Volume8
Issue number4
DOIs
StatePublished - Aug 2007

Fingerprint

Hyperemia
Manometry
Type 1 Diabetes Mellitus
Arteries
Blood Pressure
Hemoglobins
Body Mass Index
Lipids
Glucose
Aptitude
Validation Studies
Primary Prevention
Fasting
Research Design
Cardiovascular Diseases
Biomarkers
Weights and Measures

Keywords

  • Adolescents
  • Cardiovascular endothelium
  • Children/physiology
  • Prevention
  • T1D

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Haller, M. J., Stein, J., Shuster, J., Theriaque, D., Silverstein, J., Schatz, D. A., ... Mahmud, F. H. (2007). Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes. Pediatric Diabetes, 8(4), 193-198. https://doi.org/10.1111/j.1399-5448.2007.00246.x

Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes. / Haller, Michael J.; Stein, Jennifer; Shuster, Jon; Theriaque, Douglas; Silverstein, Janet; Schatz, Desmond A.; Earing, Michael G.; Lerman, Amir; Mahmud, Farid H.

In: Pediatric Diabetes, Vol. 8, No. 4, 08.2007, p. 193-198.

Research output: Contribution to journalArticle

Haller, MJ, Stein, J, Shuster, J, Theriaque, D, Silverstein, J, Schatz, DA, Earing, MG, Lerman, A & Mahmud, FH 2007, 'Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes', Pediatric Diabetes, vol. 8, no. 4, pp. 193-198. https://doi.org/10.1111/j.1399-5448.2007.00246.x
Haller, Michael J. ; Stein, Jennifer ; Shuster, Jon ; Theriaque, Douglas ; Silverstein, Janet ; Schatz, Desmond A. ; Earing, Michael G. ; Lerman, Amir ; Mahmud, Farid H. / Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes. In: Pediatric Diabetes. 2007 ; Vol. 8, No. 4. pp. 193-198.
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abstract = "Objectives: To assess the ability of reactive hyperemia-peripheral artery tonometry (RH-PAT) to serve as a surrogate marker of endothelial dysfunction in children with type 1 diabetes (T1D). Research Design and Methods: Forty-four children with T1D [age 14.6 ± 2.7 yr; duration of diabetes 6.01 ± 4 yr; range of diabetes duration 1-16 yr; and hemoglobin A1c (HbA1c) 8.34 ± 1.2{\%}] and 20 children without diabetes (age 14.1 ± 1.5 yr) underwent RH-PAT endothelial function testing after an overnight fast. Height, weight, body mass index (BMI), blood pressure (BP), fasting lipid profile, and glucose level were determined in each child. Children with T1D underwent a second RH-PAT study 4 wk after their initial study to determine the intrapatient variability of the technique. Results: Children with T1D had endothelial dysfunction as evidenced by lower mean RH-PAT scores (1.63 ± 0.5) when compared with children without diabetes (mean RH-PAT score 1.95 ± 0.3) (p = 0.01). Repeat RH-PAT scores were predicted by initial RH-PAT scores (p = 0.0025). Mean intrapatient standard deviation of RH-PAT score was 0.261 and mean coefficient of variation was 14.8. Variations in RH-PAT score were not explained by differences in glucose, HbA1c, BMI, systolic BP, diastolic BP, or lipids. Conclusions: Although larger validation studies are required, RH-PAT is a promising non-invasive technique to assess endothelial function in children with T1D. Non-invasive measures of endothelial dysfunction may provide the additional risk stratification data needed to justify more aggressive primary prevention of cardiovascular disease in children with T1D.",
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