Influence of puberty on endothelial dysfunction and oxidative stress in young patients with type 1 diabetes

• Published in: Diabetes care Vol. 21; no. 11; pp. 1990 - 1996
• Main Authors: ELHADD, T. A, KHAN, F, KIRK, G, MCLAREN, M, NEWTON, R. W, GREENE, S. A, BELCH, J. J. F
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.11.1998
• Subjects: Acetylcholine; Adolescent; Adult; Biological and medical sciences; Blood Pressure; Child; Diabetes Mellitus, Type 1 - physiopathology; Diabetes. Impaired glucose tolerance; E-Selectin - blood; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Endothelium, Vascular - physiopathology; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Humans; Intercellular Adhesion Molecule-1 - blood; Laser-Doppler Flowmetry; Male; Medical sciences; Oxidative Stress; Puberty - physiology; Regional Blood Flow - drug effects; Skin - blood supply; Vasodilation; von Willebrand Factor - analysis; United Kingdom; Europe; Endocrinopathy; Human; Immunopathology; Puberty; Induced vasodilation; Thiol; Pathophysiology; Postpuberty; Intercellular adhesion molecule 1; Enzyme; E Selectin; Red blood cell; Autoimmune disease; Superoxide dismutase; Blood plasma; Laser dopplerometry; Prepuberty; Adolescent; Young adult; Insulin dependent diabetes; Oxidoreductases; Willebrand factor; Child; Comparative study
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.21.11.1990

Influence of puberty on endothelial dysfunction and oxidative stress in young patients with type 1 diabetes. T A Elhadd , F Khan , G Kirk , M McLaren , R W Newton , S A Greene and J J Belch University Department of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK. Abstract OBJECTIVE: To examine the influence of puberty on endothelial dysfunction and oxidative stress in children and young people with type 1 diabetes. RESEARCH DESIGN AND METHODS: There were 51 young patients with type 1 diabetes, including 12 prepubertal children, 16 adolescents, and 23 young adults who had no clinical diabetic angiopathy, studied; none had microalbuminuria. The three groups were matched for glycemic control, and systolic and diastolic blood pressures and cholesterol levels were not significantly different between the groups. Endothelium-dependent vasodilatation was assessed by laser Doppler flowmetry after iontophoresis of acetylcholine (ACh) to the skin of the dorsum of the right foot. Soluble E-selectin, intercellular cell adhesion molecule-1 (ICAM-1), von Willebrand factor (vWF), plasma thiol (PSH), red cell glutathione (GSH), and red cell superoxide dismutase (SOD) were measured in blood samples obtained in the early morning. RESULTS: Skin vascular responses to ACh were significantly reduced in the young adult group compared with the prepubertal group (P < 0.05, analysis of variance). The levels of soluble ICAM-1 and E-selectin were significantly higher in the adolescent group compared with the young adult group: 338 (267-415) and 89 (64-106) ng/ml (median [interquartile range]), respectively, versus 255 (222-284) and 58 (54-71) ng/ml (P < 0.01 and P < 0.005, Mann-Whitney U test). SOD levels were significantly higher in the prepubertal group at 250 (238-282) micro/ml, when compared with the adolescent, 217 (171-249) micro/ml (P < 0.04), and young adult, 217 (157-244) micro/ml (P < 0.02), groups. GSH tended to be lower in the adolescent group, 1,192 (1,047-1,367) micromol/l, when compared with the young adults, 1,286 (1,145-1,525) pmol/l, and levels of vWF tended to be higher in the adolescent group, but these failed to reach statistical significance (both P = 0.09). PSH was not different between the three groups. CONCLUSIONS: These results suggest that puberty modulates endothelial function and antioxidant mechanisms in childhood diabetes, which may have implications for therapy and intervention.