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Impact of Obesity on Measures of Cardiovascular and Kidney Health in Youth With Type 1 Diabetes as Compared With Youth With Type 2 Diabetes.

Citation
Tommerdahl, K. L., et al. “Impact Of Obesity On Measures Of Cardiovascular And Kidney Health In Youth With Type 1 Diabetes As Compared With Youth With Type 2 Diabetes.”. Diabetes Care, pp. 795-803.
Center University of Colorado Denver
Author Kalie L Tommerdahl, Karl Baumgartner, Michal Schäfer, Petter Bjornstad, Isabella Melena, Shannon Hegemann, Amy D Baumgartner, Laura Pyle, Melanie Cree-Green, Uyen Truong, Lorna Browne, Judith G Regensteiner, Jane E B Reusch, Kristen J Nadeau
Abstract

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 ( = 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 VOpeak, 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 VOpeak 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.

Year of Publication
2021
Journal
Diabetes care
Volume
44
Issue
3
Number of Pages
795-803
Date Published
03/2021
ISSN Number
1935-5548
DOI
10.2337/dc20-1879
Alternate Journal
Diabetes Care
PMID
33402367
PMCID
PMC7896261
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