Endothelin-1 levels are decreased in pediatric type 1 diabetes and negatively correlate with the carotid intima media thickness.

AIMS Better understanding of the timeline and risk factors for the appearance of complications in pediatric type-1-diabetes is key for developing prevention strategies. We studied endothelial markers and their determinants in adolescents with type-1-diabetes at different time points from diagnosis. METHODS A cross-sectional study of 58 adolescents, mean age 15.0±2.4 years; 20 with recent-onset type-1-diabetes, 20 with over 7years of type-1-diabetes and 18 controls. Clinical and biochemical data were collected. Fingertip arterial reactive hyperemia (EndoPAT) and carotid intima-media-thickness (cIMT) were measured to assess endothelial function and structure. RESULTS Compared to controls, individuals with prolonged type-1-diabetes had higher mean cIMT (0.49±0.07mm vs. 0.43±0.05mm p=0.021) and maximal cIMT (0.61±0.08mm 0.52±0.08mm, p=0.025). Endothelin-1 levels were significantly lower in subjects with prolonged type-1-diabetes (1.2±1.0 pg/ml) compared to controls (3.0±1.7, p=0.008 pg/ml); they negatively correlated with the mean cIMT (c=-0.291, p=0.031) and mean 6 months HbA1c (c=-0.301, p=0.022) and positively correlated with mean c-peptide levels (c=0.356, p=0.006) and the weekly exercise time (c=0.485, p<0.001). Endothelin-1 levels did not correlate with EndoPAT results. CONCLUSIONS Our results suggest that the early years after the diagnosis of type-1-diabetes are an important window for prevention of arterial damage in the pediatric population. The trajectories of relationships of Endothelin-1 with metabolic and vascular measures were opposite from the anticipated, yet consistent. Endothelin-1 related indirectly to adverse measures and directly to favorable measures. Decreased Endothelin-1 levels might reflect early stages in endothelial impairment in type-1-diabetes, yet its' exact role in the development of complications is yet to be unraveled. This article is protected by copyright. All rights reserved.