Early signs of cardiovascular disease in youth with obesity and type 2 diabetes. Diabetes Care

A therosclerotic cardiovascular disease (CVD) is the major cause of mortality and morbidity in adults with type 2 diabetes (1). The origin of atherosclerosis is early in childhood with progression toward clinically significant lesions in young adulthood (2,3). Carotid artery intima media thickness (IMT) and aortic pulse wave velocity (aPWV), a measure of arterial stiffness, are noninvasive measures of subclinical atherosclerosis that have been used as surrogate measures of cardiovascular events in various adult studies (4– 9). Data regarding IMT and arterial stiffness in children are limited despite the increasing tide of obesity and type 2 diabetes. Therefore, in this pilot study, we aimed 1) to evaluate IMT and aPWV in obese adolescents with type 2 diabetes and 2) to investigate the relationship between these vascular markers and the clinical/metabolic risk factors of CVD. RESEARCH DESIGN AND METHODS We studied 20 adolescents with type 2 diabetes (undetectable islet-cell and GAD65 autoantibodies, duration 1.7 ± 0.4 years) and 22 normal-weight and 20 obese healthy control subjects. The groups were comparable for age, sex, ethnicity, and puberty assessed by Tanner criteria (10) (Table 1). Type 2 diabetic subjects were receiving either metformin o