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Publications

Journal Article Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Research Support, N.I.H., Extramural Ppublish 13 citations

PubMed: 35667385 DOI: 10.2337/dc21-2426

Longitudinal Changes in Arterial Stiffness and Heart Rate Variability in Youth-Onset Type 1 Versus Type 2 Diabetes: The SEARCH for Diabetes in Youth Study.

Diabetes Care 45(7):1647-1656

Authors: Amy S Shah, Scott Isom, Ralph D'Agostino, Lawrence M Dolan, Dana Dabelea, Giuseppina Imperatore, Amy Mottl, Eva Lustigova, Catherine Pihoker, Santica Marcovina, Elaine M Urbina

Affiliations

  • Department of Pediatrics, Cincinnati Children's Hospital Medical Center and The University of Cincinnati, Cincinnati, OH.
  • Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC.
  • Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO.
  • Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA.
  • Division of Nephrology and Hypertension, University of North Carolina School of Medicine, Chapel Hill, NC.
  • Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA.
  • Department of Pediatrics, University of Washington, Seattle, WA.
  • Department of Medicine, University of Washington, Seattle, WA.

Abstract

OBJECTIVE

We compared arterial stiffness and heart rate variability (HRV) over time by diabetes type and determined the risk factors associated with worsening arterial stiffness and HRV in young adults with youth-onset diabetes.

RESEARCH DESIGN AND METHODS

Arterial stiffness (pulse wave velocity, augmentation index) and six indices of heart rate variability were measured twice, 4.5 years apart, among participants with either youth-onset type 1 or type 2 diabetes in the SEARCH for Diabetes in Youth study. Multivariable linear regression models were used to assess risk factors associated with arterial stiffness and HRV at follow-up.

RESULTS

Of 1,159 participants studied, 949 had type 1 diabetes (mean age 17.1 ± 4.7 years, 60.3% non-Hispanic White, 55% female) and 210 had type 2 diabetes (mean age 22.1 ± 3.5 years, 23.8% non-Hispanic White, 71% female) at initial assessment when diabetes duration was 7.9 years (both groups). Participants with type 2 versus type 1 diabetes had greater arterial stiffness and more abnormalities in HRV at initial and follow-up assessment and a greater change over time (all P < 0.05). Risk factors associated with worse arterial stiffness and HRV at follow-up in both types of diabetes included higher blood pressure, hemoglobin A1c, waist circumference, and triglycerides over time and longer diabetes duration.

CONCLUSIONS

Arterial stiffness and HRV worsened over time with greater changes among participants with type 2 versus type 1 diabetes and among those with features of the metabolic syndrome. The risk factor profile documents potentially modifiable pathways to prevent or limit cardiovascular complications in young adults with youth-onset diabetes.

MeSH

Diabetes Mellitus, Heart Rate, Heart, Risk Factors, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2

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