Korean Journal of Pediatrics 2009;52(2):220-226.
Published online February 15, 2009.
A study of the development of macrovascular complications and factors related to these complications in young adults with childhood/adolescence-onset type 1 diabetes mellitus
Min Jae Kang1, Joo Hwa Kim1, Hye Rim Chung1, Young Ah Lee1, Choong Ho Shin1, Sei Won Yang1, You Yeh Kim1, Seon Mi Jin2, Chung Il Noh1
1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
2Department of Pediatrics, Eulji University School of Medicine, Seoul, Korea
소아청소년기에 1형 당뇨병으로 진단된 젊은 성인에서 대혈관 합병증의 발생과 이에 연관된 인자에 대한 연구
강민재1, 김주화1, 정혜림1, 이영아1, 신충호1, 양세원1, 김유예1, 진선미2, 노정일1
1서울대학교 의과대학 소아과학교실
2을지대학교 의과대학 소아과학교실
Correspondence: 
Choong Ho Shin, Email: chshinpd@snu.ac.kr
Abstract
Purpose
: Macrovascular complications are the main cause of mortality in type 1 diabetes mellitus (T1DM). The purpose of this study was to clarify the presence of early vascular changes and to assess the risk factors of macrovascular complications in young adults with T1DM diagnosed in childhood and adolescence.
Methods
: Seventy-two patients (23.9¡¾2.4 years) with T1DM diagnosed before 18 years of age and twenty normal controls were included. The incidence of hypertension, dyslipidemia, and other risk factors of macrovascular complication were reviewed. Flow-mediated vasodilation (FMD) and mean intima-media thickness (IMT) measured by ultrasound were compared between patients and control subjects, and their correlations with macrovascular risk factors were analyzed.
Results
: Of the 72 patients, 32 (44.4%) had hypertension. The proportions of maleness (P=0.03) and mean body mass index (P=0.04) were higher in the hypertensive patients than in normotensive patients. Thirty-one (N=69, 44.9%) patients had dyslipidemia and LDL-cholesterol was positively correlated with mean HbA1c (r=0.32, P=0.008) and total daily insulin dose (r=0.27, P=0.02). The mean IMT was significantly higher in patients than in control subjects (0.43¡¾0.06 mm vs 0.39¡¾0.06 mm, P=0.03). There was no difference in the value of FMD between patients and controls, but the duration of the disease after pubertal onset was negatively correlated with FMD (r=-0.34, P=0.01).
Conclusion
: Hypertension, dyslipidemia and atherosclerotic vascular change were observed in young adults with T1DM diagnosed during childhood and adolescence; this strongly suggests that meticulous screening of macrovascular complications and control of their risk factors should be conducted.
Key Words: Type 1 diabetes mellitus, Hypertension, Dyslipidemia, Atherosclerosis


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