ARTERIAL DYSFUNCTION IN PEDIATRIC PATIENTS WITH IMPAIRED FASTING GLUCOSE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 心血管疾病(CVD)是全球主要的死亡原因，而2型糖尿病(T2 DM)使心血管疾病的死亡风险增加了5到7倍。糖尿病前期被定义为空腹血糖受损(IFG)或糖耐量受损(IGT)的状态，与心血管疾病风险增加有关。糖尿病前期的心血管风险仍然很高，即使在很大比例的从未发展为2型糖尿病的患者中也是如此。虽然最近的数据主要是从成人研究中产生的，但儿童肥胖症流行的日益严重和儿童2型糖尿病发病率的增加需要进行研究，以确定儿童在生命早期患心血管疾病的风险。最近的成人数据表明，糖尿病前期患者中心血管疾病风险最高的可能是IFG患者。 我们假设，与性别、种族和体重指数(BMI)匹配的糖代谢正常(NGM)患者相比，IFG儿童患者有更多的血管功能障碍。桡动脉眼压计和反应性充血外周动脉眼压计(RH-PAT)是动脉硬度和血管内皮功能的两种无创性替代测量，已被用于预测成人未来的CVD，并已被用于显示其他心血管风险增加的儿童人群的异常。我们将对10-18岁的IFG患者进行放射状眼压测量和RH-PAT测量。记录患有IFG的儿童动脉僵硬和内皮功能障碍将支持对患有IFG的儿童人群进行积极的干预，以预防与心血管疾病相关的发病率和死亡率。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Cardiovascular disease (CVD) is the leading cause of death worldwide and Type 2 diabetes mellitus (T2DM) increases the risk of death from CVD by 5 to 7 times. Pre-diabetes, defined as a state of either impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), is associated with an increased risk of CVD. The CVD risk in pre-diabetes remains elevated even in the large percentage of patients who never go on to develop type 2 diabetes. While recent data have largely been generated from adult research studies, the growing pediatric obesity epidemic and increasing incidence of type 2 diabetes in children necessitates research aimed at identifying children at risk for developing CVD early in life. Recent adult data have demonstrated that the highest CVD risk amongst pre-diabetes subjects may be in those with IFG. We hypothesize that pediatric patients with IFG have more vascular dysfunction than sex-, race-, and body mass index (BMI)-matched patients with normal glucose metabolism (NGM). Radial artery tonometry and reactive hyperemia peripheral artery tonometry (RH-PAT) are two noninvasive surrogate measurements of arterial stiffness and endothelial function that have been used to predict future CVD in adults and have been used to demonstrate abnormalities in other pediatric populations with elevated CVD risk. We will obtain radial tonometry and RH-PAT measurements in patients 10-18 years of age with IFG. Documentation of increased arterial stiffness and endothelial dysfunction in children with IFG will support aggressive intervention in pediatric populations with IFG to prevent morbidity and mortality associated with CVD.