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28 September 2019 : Clinical Research

Two-Dimensional Speckle Tracking Versus Applanation Tonometry in Evaluation of Subclinical Atherosclerosis in Children with Type 1 Diabetes Mellitus

Michał Podgórski1ABCDEF*, Katarzyna Szatko1BDF, Małgorzata Stańczyk2BCD, Monika Pawlak-Bratkowska2BCDE, Michał Fila3BCDEF, Ewa Bieniek4ABEF, Marcin Tkaczyk2ADEF, Piotr Grzelak1ABDE, Maciej Łukaszewski1ABCDEFG

DOI: 10.12659/MSM.916466

Med Sci Monit 2019; 25:7289-7294


BACKGROUND: Patients with type 1 diabetes mellitus (T1DM) often develop atherosclerosis at an early age. In the subclinical stage of the process, minimal/non-morphological changes can be noticed, but the arterial wall function can be impaired. Applanation tonometry allows to assess the arterial tree stiffness; however, the Two-Dimensional Speckle Tracking (2DST) is an increasingly accepted alternative. This study evaluated arterial wall stiffness using these 2 techniques in children with T1DM.

MATERIAL AND METHODS: We performed applanation tonometry and carotid arteries sonography with evaluation of the carotid intima-media thickness (cIMT) and use of the 2DST in 50 children with T1DM and in 50 healthy sex- and age-matched controls. We also assessed the reliability of 2DST in 10 random subjects.

RESULTS: Children with T1DM had increased arterial wall stiffness, which was confirmed by tonometry (PWV: p=0.0386) and 2DST (Strain: p=0.0004; Strain rate: p=0.0081). There was no significant difference in cIMT between groups (0.45±0.06 vs. 0.43±0.05, p=0.073 in children with T1DM and controls, respectively). 2DST presented good intraclass correlation coefficient between researchers and within a single researcher.

CONCLUSIONS: Children with T1DM presenting with subclinical stage of atherosclerosis were found to have arterial wall stiffening. The 2DST, the same as applanation tonometry, allows to recognize this condition but in a more accessible and reproducible manner.

Keywords: Arteriosclerosis, carotid intima-media thickness, Diabetes Mellitus, Type 1, Pediatrics, Ultrasonography


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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750