Adolescents with severe obesity show a higher cardiovascular (CV) risk than those with type 1 diabetes: a study with skin advanced glycation end products and intima media thickness evaluation.
Adolescent
Blood Pressure
Cardiovascular Diseases
/ epidemiology
Cardiovascular System
/ physiopathology
Carotid Intima-Media Thickness
Child
Cholesterol, LDL
/ blood
Diabetes Mellitus, Type 1
/ complications
Female
Glycation End Products, Advanced
/ metabolism
Humans
Male
Obesity, Morbid
/ complications
Prospective Studies
Risk Factors
Skin
/ metabolism
Triglycerides
/ blood
Adolescents
Advanced glycation end products
Cardiovascular risk
Intima media thickness
Obesity
Type 1 diabetes
Journal
Acta diabetologica
ISSN: 1432-5233
Titre abrégé: Acta Diabetol
Pays: Germany
ID NLM: 9200299
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
27
12
2019
accepted:
11
04
2020
pubmed:
7
6
2020
medline:
15
12
2020
entrez:
7
6
2020
Statut:
ppublish
Résumé
Type 1 diabetes (T1D) and obesity are strongly associated with cardiovascular (CV) risk and can start in the paediatric age. The CV risk profile of two groups of adolescents was compared through the evaluation of sAGE, IMT and known variables associated with CV risk. The first group was affected by T1D with duration of disease of at least 5 years or 3 years since puberty onset, and the second by severe obesity for more than 3 years. A total of 116 patients were prospectively enrolled in the study (71 T1D, 33 males and 38 females; 45 obese, 18 males and 27 females), and their sAGE, IMT, waist/height ratio, LDL cholesterol, triglycerides/cholesterol HDL ratio, BMI, HbA1c and blood pressure were measured. An IMT value > 0.7 mm, cut-off value to define CV risk, was present in 28% of the obese patients and in no T1D patients. Age-adjusted sAGE and HbA1c levels were higher T1D patients, whereas a higher percentage of pathological values was present in most of the remaining studied variables. In T1D patients, there was a higher percentage of females with waist/height ratio > 0.5, LDL cholesterol > 100 mg/dL, triglycerides/HDL cholesterol ratio > 2 and BMI > 99° centile and a higher percentage of males with HbA1c > 7%. On the contrary, in obese patients there were no differences between males and females. Multiple analysis is identified BMI SDS as the only variable with a significant influence on IMT in both groups. Furthermore, it showed that HbA1c and gender affected sAGE in T1D patients, whereas only age and gender in the obese patients. Our study demonstrates that our adolescents with severe obesity carry a much higher CV risk than adolescents with T1D unless in bad metabolic control. Apart from lower sAGE levels, most of the variables considered to define CV risk were higher in the obese group than in the T1D group. Gender seems to have a significant impact on sAGE levels but not on IMT.
Identifiants
pubmed: 32504306
doi: 10.1007/s00592-020-01537-1
pii: 10.1007/s00592-020-01537-1
doi:
Substances chimiques
Cholesterol, LDL
0
Glycation End Products, Advanced
0
Triglycerides
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1297-1305Commentaires et corrections
Type : CommentIn
Type : CommentIn
Références
Singh R, Barden A, Mori T, Beilin L (2001) Advanced glycation end-products: a review. Diabetologia 44:129–146
doi: 10.1007/s001250051591
Basta G, Schmidt AM, De Caterina R (2004) Advanced glycation end products and vascular inflammation: implications for accelerated atherosclerosis in diabetes. Cardiovasc Res 63:582–592
doi: 10.1016/j.cardiores.2004.05.001
Takeuchi M, Takino JI, Yamagishi SI (2010) Involvement of the toxic AGEs (TAGE) RAGE system in the pathogenesis of diabetic vascular complications: a novel therapeutic strategy. Curr Drug Target 11:1468–1482
doi: 10.2174/1389450111009011468
Lind M, Svensson AM, Kosiborod M, Gudbjörnsdottir S, Pivodic A, Wedel H, Dahlqvist S, Clements M, Rosengren A (2014) Glycemic control and excess mortality in type 1 diabetes. N Engl J Med 371(21):1972–1982
doi: 10.1056/NEJMoa1408214
Lee EY, Yoon KH (2018) Epidemic obesity in children and adolescents: risk factors and prevention. Front Med 12(6):658–666
doi: 10.1007/s11684-018-0640-1
NCDRisk Factor Collaboration (NCD-RisC) (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 390:2627–2642
doi: 10.1016/S0140-6736(17)32129-3
Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet 365:1415–1428
doi: 10.1016/S0140-6736(05)66378-7
Romero-Corral A, Montori VM, Somers VK, Korinek J, Thomas RJ, Allison TG et al (2006) Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet 368(9536):666–678
doi: 10.1016/S0140-6736(06)69251-9
Bojestig M, Arnqvist HJ, Hermansson G, Karlberg BE, Ludvigsson J (1994) Declining incidence of nephropathy in insulin-dependent diabetes mellitus. N Engl J Med 330:15–18
doi: 10.1056/NEJM199401063300103
Downie E, Craig ME, Hing S, Cusumano J, Chan AKF, Donaghue KC (2011) Continued reduction in the prevalence of retinopathy in adolescents with type 1 diabetes: role of insulin therapy and glycemic control. Diabetes Care 34:2368–2373
doi: 10.2337/dc11-0102
Meerwaldt R, Graaff R, Oomen PHN et al (2004) Simple noninvasive assessment of advanced glycation endproduct accumulation. Diabetologia 47(7):1324–1330
doi: 10.1007/s00125-004-1451-2
Genevieve M, Vivot A, Gonzalez C et al (2013) Skin autofluorescence is associated with past glycaemic control and complications in type 1 diabetes mellitus. Diabetes Metab 39:349–354
doi: 10.1016/j.diabet.2013.03.003
Conway BN, Aroda VR, Maynard JD, Matter N, Fernandez S, Ratner RE, Orchard TJ (2012) Skin intrinsic fluorescence is associated with coronary artery disease in individuals with long duration of type 1 diabetes. Diabetes Care 35:2331–2336
doi: 10.2337/dc12-0053
Van Waateringe RP, Slagter SN, van Beek AP et al (2017) Skin autofluorescence, a non-invasive biomarker for advanced glycation end products, is associated with the metabolic syndrome and its individual components. Diabetol Metab Syndr 9(1):42
doi: 10.1186/s13098-017-0241-1
Banser A, Naafs JC, Hoorweg-Nijman JJ, van de Garde EM, van der Vorst MM (2016) Advanced glycation end products, measured in skin, vs. HbA1c in children with type 1 diabetes mellitus. Pediatr Diabetes 17(6):426–432
doi: 10.1111/pedi.12311
Van der Heyden JC, Birnie E, Mul D, Bovenberg S, Veeze HJ, Aanstoot HJ (2016) Increased skin autofluorescence of children and adolescents with type 1 diabetes despite a well-controlled HbA1c: results from a cohort study. BMC Endocr Disord 16(1):49
doi: 10.1186/s12902-016-0129-3
Cho YH, Craig ME, Januszewski AS, Benitez-Aguirre P, Hing S, Jenkins AJ, Donaghue KC (2017) Higher skin autofluorescence in young people with Type 1 diabetes and microvascular complications. Diabet Med 34(4):543–550
doi: 10.1111/dme.13280
Den Engelsen C, van den Donk M, Gorter KJ, Salomé PL, Rutten GE (2012) Advanced glycation end products measured by skin autofluorescence in a population with central obesity. Dermatoendocrinol 4(1):33–38
doi: 10.4161/derm.17999
Lentferink YE, van Teeseling L, Knibbe CAJ, van der Vorst MMJ (2019) Skin autofluorescence in children with and without obesity. J Pediatr Endocrinol Metab 32(1):41–47
doi: 10.1515/jpem-2018-0237
Järvisalo MJ, Putto-Laurila A, Jartti L, Lehtimäki T, Solakivi T, Rönnemaa T, Raitakari OT (2002) Carotid intima-media thickness in children with type 1 diabetes. Diabetes 51:493–498
doi: 10.2337/diabetes.51.2.493
Wunsch R, de Sousa G, Toschke AM, Reinehr T (2006) Intima-media thickness in obese children before and after weight loss. Pediatrics 118(6):2334–2340
doi: 10.1542/peds.2006-0302
Park MH, Skow Á, De Matteis S, Kessel AS, Saxena S, Viner RM, Kinra S (2015) Adiposity and carotid-intima media thickness in children and adolescents: a systematic review. BMC Pediatr 16(15):161
doi: 10.1186/s12887-015-0478-5
Valerio G, Maffeis C, Saggese G, Ambruzzi MA, Balsamo A, Bellone S et al (2018) Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Ital J Pediatr 44(1):88
doi: 10.1186/s13052-018-0525-6
Lurbe E, Agabiti-Rosei E, Cruickshank JK, Dominiczak A, Erdine S, Hirth A, Invitti C, Litwin M, Mancia G, Pall D, Rascher W, Redon J, Schaefer F, Seeman T, Sinha M, Stabouli S, Webb NJ, Wühl E, Zanchetti A (2016) 2016 European Society of hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens 34(10):1887–1920
doi: 10.1097/HJH.0000000000001039
Manco M, Grugni G, Di Pietro M, Balsamo A, Di Candia S, Morino GS, Franzese A, Di Bonito P, Maffeis C, Valerio G (2016) Triglycerides-to-HDL cholesterol ratio as screening tool for impaired glucose tolerance in obese children and adolescents. Acta Diabetol 53(3):493–498
doi: 10.1007/s00592-015-0824-y
Di Bonito P, Moio N, Scilla C, Cavuto L, Sibilio G, Sanguigno E, Forziato C, Saitta F, Iardino MR, Di Carluccio C, Capaldo B (2012) Usefulness of the high triglyceride-to-HDL cholesterol ratio to identify cardiometabolic risk factors and preclinical signs of organ damage in outpatient children. Diabetes Care 35(1):158–162
doi: 10.2337/dc11-1456
Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 115(4):459–467
doi: 10.1161/CIRCULATIONAHA.106.628875
Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH (1992) Long-term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 327:1350–1355
doi: 10.1056/NEJM199211053271904
Gunnell DJ, Frankel SJ, Nanchahal K, Peters TJ, Davey Smith G (1998) Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. Am J Clin Nutr 67:1111–1118
doi: 10.1093/ajcn/67.6.1111
van Waateringe RP, Fokkens BT, Slagter SN, van der Klauw MM, van Vliet-Ostaptchouk JV, Graaff R, Paterson AD, Smit AJ, Lutgers HL, Wolffenbuttel BHR (2019) Skin autofluorescence predicts incident type 2 diabetes, cardiovascular disease and mortality in the general population. Diabetologia 62(2):269–280
doi: 10.1007/s00125-018-4769-x
Valerio G, Iafusco D, Zucchini S, Maffeis C (2012) Study-group on diabetes of Italian Society of Pediatric Endocrinology and Diabetology (ISPED). Abdominal adiposity and cardiovascular risk factors in adolescents with type 1 diabetes. Diabetes Res Clin Pract. 97(1):99–104
doi: 10.1016/j.diabres.2012.01.022
Köchli S, Endes K, Trinkler M, Mondoux M, Zahner L, Hanssen H (2019) Association of physical fitness with skin autofluorescence-derived advanced glycation end products in children. Pediatr Res 2
Gill V, Kumar V, Singh K, Kumar A, Kim JJ (2019) Advanced glycation end products (AGEs) may be a striking link between modern diet and health. Biomolecules 9(12):888
doi: 10.3390/biom9120888
The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986
doi: 10.1056/NEJM199309303291401
White NH, Sun W, Cleary PA et al (2010) Effect of prior intensive therapy in type 1 diabetes on 10-year progression of retinopathy in the DCCT/EDIC: comparison of adults and adolescents. Diabetes 59:1244–1253
doi: 10.2337/db09-1216
Bancks MP, Ning H, Allen NB, Bertoni AG, Carnethon MR, Correa A, Echouffo-Tcheugui JB, Lange LA, Lloyd-Jones DM, Wilkins JT (2019) Long-term absolute risk for cardiovascular disease stratified by fasting glucose level. Diabetes Care 42(3):457–465
doi: 10.2337/dc18-1773