Journal
DIABETES CARE
Volume 44, Issue 3, Pages 795-803Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc20-1879
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Funding
- National Institutes of Health (NIH) [T32 DK-063687, DK-007135]
- Center for Women's Health Research at the University of Colorado
- NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [K23 DK116720]
- JDRF [2-SRA-2018-627-M-B, 2-SRA-2019-845-S-B]
- Boettcher Foundation
- Graduate Experiences for Multicultural Students Program
- NIH National Heart, Lung, and Blood Institute (NHLBI) [5 K24 HL145076-02]
- American Health Association [13CRP 14120015]
- Thrasher Pediatric Research Foundation Mentored Pilot Grant
- NIH National Center for Research Resources Colorado Clinical and Translational Sciences Institute (CCTSI) Co-Pilot grant [TL1 RR025778]
- Pediatric Endocrinology Society Fellowship
- NIH NIDDK [K23 DK107871]
- Denver Research Institute, CCTSI grant [IL1 RR025780]
- Center for Women's Health Research
- Armstrong Foundation [BX002046, UL1 TR002535]
- American Diabetes Association grant [7-11-CD-08, 11-2010-343]
- NIH NHLBI [5 K24 HL145076-02]
- NIH National Center for Advancing Translational Sciences Colorado Clinical and Translational Science Award [UL1 TR002535]
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The study evaluated the impact of BMI on cardiovascular and kidney outcomes in youth with T1D and T2D, finding that obese adolescents with T1D have a higher cardiovascular and kidney disease risk profile, similar to youth with T2D.
OBJECTIVE Insulin resistance and obesity are independently associated with type 1 diabetes (T1D) and are known risk factors for cardiovascular and kidney diseases, the leading causes of death in T1D. We evaluated the effect of BMI on cardiovascular and kidney outcomes in youth with T1D versus control youth with normal weight or obesity and youth with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS Pubertal youth (n = 284) aged 12-21 years underwent assessments of resting heart rate (RHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP), leptin, hs-CRP, adiponectin, ratio of urine albumin to creatinine, and estimated glomerular filtration rate. Participants with T1D underwent bicycle ergometry for VO(2)peak, monitoring for peripheral brachial artery distensibility (BAD), endothelial function testing for reactive hyperemic index, and aortic MRI for central arterial stiffness or shear. RESULTS In adolescents with T1D, RHR, SBP, DBP, mean arterial pressure, leptin, hs-CRP, and hypertension prevalence were significantly higher, and BAD, descending aorta pulse wave velocity, and VO(2)peak lower with an obese versus normal BMI. Although hypertension prevalence and RHR were highest in obese adolescents with T1D and adiponectin lowest in youth with T2D, other measures were similar between obese adolescents with T1D and those with T2D. CONCLUSIONS Obesity, now increasingly prevalent in people with T1D, correlates with a less favorable cardiovascular and kidney risk profile, nearly approximating the phenotype of youth with T2D. Focused lifestyle management in youth-onset T1D is critically needed to reduce cardiovascular risk.
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