Predictors of Arterial Stiffness in Adolescents and Adults with Type 1 Diabetes: A Cross-Sectional Study

Introduction: Individuals with type 1 diabetes have increased arterial stiffness compared to age-matched healthy controls. Our aim was to determine which hemodynamic and demographic factors predict arterial stiffness in this population. Research Design and Methods: Carotid-femoral pulse wave velocity (cfPWV) was examined in 41 young adults and adolescents with type 1 diabetes without microvascular complications. Two ordinary least squares regression analyses were performed to determine multivariate relationships between cfPWV [loge] and: 1) age, duration of diabetes, sex, and HbA1c, and 2) augmentation index (AIx), mean arterial pressure, flow-mediated dilation (FMD), and heart rate. We also examined differences in macrovascular outcome measures between sexes. Results: Age, sex, and FMD provided unique predictive information about cfPWV in these participants with type 1 diabetes. Despite having similar cardiovascular risk factors, males had higher cfPWV compared to females but no differences were observed in other macrovascular outcomes (including FMD and AIx). Conclusions: Only age, sex, and FMD were uniquely associated with arterial stiffness in adolescents and adults with uncomplicated type 1 diabetes. Females had less arterial stiffness and similar nitric-oxide dependent endothelial function compared to males. Larger, prospective investigation is warranted to determine the temporal order of and sex-differences in arterial dysfunction in type 1 diabetes.