Insulin sensitivity and arterial stiffness in youth with type 1 diabetes: the SEARCH CVD study

Abstract Aims Decreased insulin sensitivity is a cardiovascular risk factor (CVRF) in youth with type 1 diabetes (T1D). Whether baseline insulin sensitivity is independently associated with changes in early arterial stiffness (pulse wave velocity (PWV)) over time in youth with T1D is not known. Meth...

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Published in:Journal of diabetes and its complications 2015-05, Vol.29 (4), p.512-516
Main Authors: Shah, Amy S, Black, Sandra, Wadwa, R. Paul, Schmiege, Sarah J, Fino, Nora F, Talton, Jennifer W, D’Agostino, Ralph, Hamman, Richard F, Urbina, Elaine M, Dolan, Lawrence M, Daniels, Stephen R, Marcovina, Santica M, Dabelea, Dana
Format: Article
Language:English
Subjects:
Adolescent
Age
Blood pressure
Body mass index
Cardiovascular disease
Cardiovascular Diseases - etiology
Cardiovascular Diseases - metabolism
Cardiovascular Diseases - physiopathology
Child
Cohort Studies
Diabetes
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - metabolism
Diabetes Mellitus, Type 1 - physiopathology
Endocrinology & Metabolism
Ethnicity
Family medical history
Female
Hispanic people
Humans
Insulin
Insulin Resistance
Longitudinal Studies
Low density lipoprotein
Male
Metabolism
Mortality
Pediatrics
Pulse Wave Analysis
Pulse wave velocity
Race
Risk Factors
Triglycerides
Type 1 diabetes
Vascular Stiffness
Velocity
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Summary:Abstract Aims Decreased insulin sensitivity is a cardiovascular risk factor (CVRF) in youth with type 1 diabetes (T1D). Whether baseline insulin sensitivity is independently associated with changes in early arterial stiffness (pulse wave velocity (PWV)) over time in youth with T1D is not known. Methods Two hundred ninety-eight youth with T1D in the SEARCH CVD study had PWV measured ~ five years apart. Insulin sensitivity and other CVRFs were measured at baseline. The association between baseline insulin sensitivity with PWV over time was explored using linear mixed models. Models were adjusted for baseline age, sex and race, with subsequent adjustment for CVRFs. Results There was a significant interaction (p = 0.0326) between baseline insulin sensitivity and time on PWV, independent of CVRFs, indicating that higher insulin sensitivity levels were associated with lower rate of change in PWV over time. Other significant predictors of PWV change were baseline age [β = 0.007 (p = 0.03) increase in logPWV/year increase in age] and mean arterial blood pressure (MAP) [β = 0.005 (p < 0.01) increase in logPWV/mmHg increase in MAP] and smoking status (current vs. never smoker). Conclusions Lower insulin sensitivity at baseline appears to be an important risk factor for increased arterial stiffness over time in youth with T1D. This identifies a potentially modifiable therapeutic target.
ISSN:1056-8727
1873-460X
DOI:10.1016/j.jdiacomp.2015.02.004