Abstract 13620: Aortic Distensibility, Assessed by MRI, is Decreased in Adolescents with Type 1 Diabetes Mellitus and Elevated LDL-C

Abstract

Background: Children with type 1 diabetes (T1DM) have increased risk for accelerated cardiovascular disease (CVD) development. CVD remains the principal risk of mortality in T1DM, making its prevention and treatment compelling in the pediatric population.

Objective: To determine whether children with T1DM and elevated LDL-C have evidence of aortic stiffness using cardiac MRI.

Methods: MRIs were performed at two Nemours sites using a 1.5T GE scanner on 41 adolescents, 21 with T1DM , 20 healthy controls (CON). Those with T1DM had diabetes >1yr, normotension, BMI < 95%ile and a fasting LDL-C ≥ 90 mg/dL. CON adolescents had no CVD risk factors and normal BMI. T1 weighted, double IR sequences of the aortic arch from which single slice, ECG-gated, breath held steady state free precession and phase encoded sequences were obtained and then analyzed using the semi-automated program ARTFUN to calculate strain and distensibility of the ascending (AscAo) and descending (DescAo) thoracic aorta and pulse wave velocity (PWV) of the aortic arch. Lipid subfractions were measured using an ion mobility assay (Quest Diagnostics) and HbA1C by DCA 2000. Non-parametric Spearman correlations are reported with corresponding P-values.

Results: Data shown in table 1 as mean ± SD. Mean ages were slightly older in those with T1DM but with similar ranges and pubertal stage. BMI was negatively correlated with DescAo distensibility (r=-0.298, p=0.058). In subgroup analysis of T1DM patients, total cholesterol (r=-0.221, p=0.378) and LDL levels (r=-0.236, p=0.346) were inversely but not significantly correlated with DescAo distensibility. In T1DM, HbA1C was negatively correlated with distensibility measurements, particularly of the DescAo (r= -0.514, p=0.017)

Conclusions: Adolescents with T1DM and elevated LDL-C have a stiffer aorta than healthy non-diabetic patients; stiffness is directly related to diabetes control and may be a viable measure of subclinical atherosclerotic disease.