Sirvi Autor "Heilman, Kaire" järgi

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Insuliinipumpade kasutamine laste 1. tüüpi diabeedi ravis: tervisetehnoloogia hindamise raport TTH03
(2013) Lutsar, Katrin; Heilman, Kaire; Simre, Kärt; Kiivet, Raul-Allan; Tartu Ülikool. Tervishoiu instituut
Risk markers for cardiovascular disease and low bone mineral density in children with type 1 diabetes
(2009-11-16T09:16:11Z) Heilman, Kaire
Cardiovascular disease (CVD) is the leading cause of death in people with type 1 diabetes (DM1). In this study we looked at biochemical risk markers of CVD, as well as atherosclerosis-related structural and functional chan¬ges of the arterial wall in children with DM1. Compared to healthy controls, children with DM1 had elevated markers of systemic inflammation (high-sensitivity C-reactive protein), endothelial activation (intercellular cell adhesion molecule-1) and cellular inflammation and oxidative stress (myeloperoxidase). Children with diabetes had higher levels of adiponectin and lower levels of novel atherosclerotic metabolite risk markers (asymmetric dimethylarginine, homocysteine). Systemic oxidative stress (measured by urinary 8-iso-prostaglandin F2a levels) did not differ between children with diabetes and healthy controls. The levels of traditional markers of dyslipidemia did not differ between the diabetes and control groups. Children with DM1 had increased carotid intima-media thickness (IMT) and arterial stiffness. Increased IMT was associated with poor glycaemic control in children with DM1. These results suggest that children with diabetes have atherosclerosis-related changes of the arterial wall as early as five years after the diagnosis. An association has been reported between CVD and osteoporosis. Previous studies have shown that patients with DM1 are also at risk of decreased bone mineral density (BMD) and bone fractures. This study evaluated different BMD parameters in children with DM1. Compared to healthy children, children with DM1 had lower BMD, which was particularly seen in the boys. Poor glycaemic control, elevated markers of inflammation (intercellular cell adhesion molecule-1) and oxidative stress (8-iso-prostaglandin F2a) were associated with lower BMD in patients with DM1. Therefore it is important to pay early attention also to BMD in those patients in addition to classical vascular complications.