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Publications

Journal Article Research Support, N.I.H., Extramural Ppublish 40 citations

PubMed: 25736026 DOI: 10.1016/j.jdiacomp.2015.02.004

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

J Diabetes Complications 29(4):512-6

Authors: Amy S Shah, Sandra Black, R Paul Wadwa, Sarah J Schmiege, Nora F Fino, Jennifer W Talton, Ralph D'Agostino, Richard F Hamman, Elaine M Urbina, Lawrence M Dolan, Stephen R Daniels, Santica M Marcovina, Dana Dabelea

Affiliations

  • Cincinnati Children's Hospital, Cincinnati, OH USA.
  • Colorado School of Public Health, Aurora, CO USA.
  • Barbara Davis Center for Childhood Diabetes, Aurora, CO USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO USA.
  • Wake Forest School of Medicine, Winston-Salem, NC USA.
  • Cincinnati Children's Hospital, Cincinnati, OH USA.
  • Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO USA.
  • Northwest Lipid Metabolism and Diabetes Research, University of Washington, Seattle, WA USA.

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.

MeSH

Insulin, Risk Factors, Diabetes Complications, Diabetes Mellitus, Type 1

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