P-320: Structural equation modeling identifies distinct metabolic and inflammatory pathways associated with early vascular damage in children and adolescents with type 1 diabetes
A G Krochik, C Barcala, M Prieto, C P Martinez Mateu, V A Schulmaeister, M B AraujoAbstract
Introduction
Childhood-onset type 1 diabetes (T1D) is associated with early subclinical atherosclerosis. However, interactions between cardiovascular risk factors and early vascular damage remain poorly characterized, particularly in Latin American youth.
Objectives
To evaluate the association between cardiovascular risk factors and carotid intima-media thickness (cIMT) using structural equation modeling.
Methods
Cross-sectional study including 223 children and adolescents with T1D. Clinical, anthropometric, metabolic, inflammatory, renal, advanced lipid parameters and cIMT were assessed. Direct and indirect associations were explored using structural equation modeling.
Results
Mean age was 12.3±3.6 years and median diabetes duration was 5 years. Only 21% achieved HbA1c ≤7%. A strong atherogenic lipid cluster was identified between ApoB and small dense LDL (r=0.75). HbA1c (β=0.20) and diabetes duration (β=0.19) were associated with higher triglycerides, which were associated with small dense LDL (β=0.30). cIMT was independently associated with hs-CRP (β=0.21) and age (β=0.25), but not with HbA1c or conventional lipid parameters.
Conclusions
Early cardiovascular risk in youth with T1D involves distinct metabolic and inflammatory pathways. Systemic inflammation was associated with vascular damage, whereas poor glycemic control was linked to a more atherogenic lipid profile.