LARGE VESSEL DYSFUNCTION IN DIABETIC ADOLESCENTS AND ITS RELATIONSHIPTO SMALL VESSEL COMPLICATIONS

Endothelial dysfunction is considered a key early event in atheroscler osis, Using a novel ultrasound method, brachial artery endothelial and smooth muscle physiology were studied in 20 adolescents with IDDM and compared to that in 20 nondiabetic subjects matched for age (1322 yea rs), gender and vessel size, Endothelium-dependent dilatation (EDD) wa s assessed in response to flow (EDD) and endothelium-independent vasod ilatation after sublingual glyceryl trinitrate (GTN), Both EDD and GTN were reduced in those with IDDM compared with controls: 5% vs 9%, (p= 0.0002) and 14% vs 21% (p=0.002), Abnormal EDD was found in 12 IDDM ad olescents (diabetes duration 3.3-14.9 years), The maximum albumin excr etion rate of the diabetic group was 17 mu g/min, Four adolescents had retinopathy assessed by stereoscopic fundus photography, Three had at least one of four cardiovascular autonomic test abnormalities, There was no significant correlation observed between the test for early lar ge vessel disease and those for diabetic microangiopathy, Large vessel dysfunction was the most common abnormality.