Endocrine Abstracts

JOINT2428

Introduction: In 2022, type 1 diabetes (T1D) prevalence in youth was estimated at 1. 52 million, listing it among the most common pediatric chronic conditions. The T1D pediatric population has been identified to be at higher risk of cardiovascular morbidity and mortality. Lower cardiorespiratory fitness (VO₂ peak) has been associated with higher cardiovascular mortality in the adult population. However, no studies have examined the effect of VO₂ peak on early markers of cardiovascular disease in youth with type 1 diabetes.

Objective: To assess the association between VO₂ peak and early markers of CVD in adolescents with and without T1D and determine differences across groups.

Methods: This is a cross-sectional study conducted in the CARDEA cohort consisting of adolescents (14-18 years of age) with T1D (n = 100) and without T1D (n = 97). VO₂ peak was measured on an electromagnetic bicycle during an incremental exercise test. The morphological cardiac outcomes were assessed using cardiac magnetic resonance imaging. For vascular outcomes, flow-mediated dilation was used to evaluate endothelial function, and arterial stiffness was estimated using pulse-wave velocity. Multivariable linear regressions were adjusted for age, sex, ethnicity, diabetes, household income, physical activity (accelerometry), and heart rate. Differences between groups were tested using an interaction term between T1D status and VO₂ peak.

Results: In comparison to the control group, adolescents with T1D had a lower VO₂ peak, MVPA and familial income, while they had higher daily screen time. A higher VO₂ peak was associated with higher left ventricle (LV) papillary mass (0. 04 g; 95% CI: 0. 01; 0. 06) and LV end-systolic volume (0. 37 mls; 95% CI: 0. 07; 0. 67). In contrast, higher VO₂ peak was associated with a lower LV wall thickness (-0. 10 mm; 95% CI: -0. 19, -0. 01). There were no meaningful associations between VO₂ peak and endothelial function or arterial stiffness. No differences in associations were found between T1D participants and controls.

Conclusion: Overall, adolescents with T1D had lower cardiorespiratory fitness and poorer lifestyle habits compared to controls. Our results indicate that higher cardiorespiratory fitness is linked to favorable cardiac morphology but not vascular function, irrespective of T1D status.