Abstract 12763: Adolescents With Type 1 Diabetes Show Early Hemodynamic and Vascular Changes Unrelated to Standard Glucose and Lipid Markers

Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in patients with type 1 diabetes (T1D). There is increasing evidence that maladaptive changes in vascular properties occur early in adolescence. Wall shear stress (WSS) plays crucial role in mechanotransduction and tissue remodeling. However, changes in aortic WSS and vascular properties in T1D adolescents and their associations with T1D biomarkers have yet to be determined. Hypothesis: We hypothesized that non-invasively MRI derived WSS and vascular markers of stiffness will be altered in T1D adolescents. Methods: Fourteen adolescents with T1D and 25 age-matched controls underwent prospective phase-contrast MRI (PC-MRI). Segmented cross sectional planes were selected above the sinotubular junction, transverse to the descending aorta. Maximum WSS values were computed from time specific generated shear fields. Aortic strain (AoS), distensibility (Ds), and stiffness index β (SI) were computed using vessel areas and pulse pressure. All measured hemodynamic and vascular markers were correlated with standard T1D biomarkers: A1C hemoglobin, cholesterol, LDL, HDL, and triglyceride levels. The significance between reported median values was assessed using Wilcoxon Ranked sum method and single linear regression analysis using Spearman rho. Results: Subjects with T1D showed significantly increased maximum WSS (dyne/cm2) in both ascending aorta (11.1 vs. 9.02, p = 0.0065) and descending aorta (13.7 vs. 12.3, p = 0.0166). Furthermore, AoS and Ds (mmHg-1) were both decreased in T1D group in ascending aorta (AoS: 25.1 vs. 29.7, p = 0.0352; Ds: 0.49 vs. 0.71, p = 0.0151) and descending aorta (AoS: 20.1 vs. 26.5, p = 0.0002; Ds: 0.41 vs. 0.66, p = 0.0082). Inversely, SI was higher in T1D group in both vessel segments (0.030 vs. 0.018, p = 0.0021 and 0.034 vs. 0.020, p = 0.0017). There were no significant correlations between PC-MRI derived vascular metrics and collected biomarkers. Conclusions: T1D adolescents show early aortic stiffness and altered WSS. Neither WSS nor stiffness markers correlated with A1C hemoglobin or lipid biomarkers. This suggests that potential therapeutic targets of the early vascular remodeling are beyond standard glycemic and lipid control.