Beschreibung:
<jats:p><jats:italic>Background</jats:italic>. Type 1 diabetes is a chronic disease including hyperglycemia and accelerated atherosclerosis, with high risk of micro- and macrovascular complications. Circulating microvesicles (cMVs) are procoagulant cell fragments shed during activation/apoptosis and discussed to be markers of vascular dysfunction and hypercoagulability. Limited knowledge exists on hypercoagulability in young diabetics. We aimed to investigate cMVs over a five-year period in children/adolescents with type 1 diabetes compared with controls and any associations with glycemic control and cardiovascular risk factors. We hypothesized increased shedding of cMVs in type 1 diabetes in response to vascular activation. <jats:italic>Methods</jats:italic>. The cohort included type 1 diabetics (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn>40</mml:mn></mml:math>) and healthy controls (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn>40</mml:mn></mml:math>), mean age 14 years (range 11) at inclusion, randomly selected from the Norwegian Atherosclerosis and Childhood Diabetes (ACD) study. Citrated plasma was prepared and stored at -80°C until cMV analysis by flow cytometry. <jats:italic>Results</jats:italic>. Comparable levels of Annexin V (AV<jats:sup>+</jats:sup>) cMVs were observed at inclusion. At five-year follow-up, total AV<jats:sup>+</jats:sup> cMVs were significantly lower in subjects with type 1 diabetes compared with controls; however, no significant differences were observed after adjusting for covariates. In the type 1 diabetes group, the total AV<jats:sup>+</jats:sup>, tissue factor-expressing AV<jats:sup>+</jats:sup>/CD142<jats:sup>+</jats:sup>, neutrophil-derived AV<jats:sup>+</jats:sup>/CD15<jats:sup>+</jats:sup> and AV<jats:sup>+</jats:sup>/CD45<jats:sup>+</jats:sup>/CD15<jats:sup>+</jats:sup>, and endothelial-derived AV<jats:sup>+</jats:sup>/CD309<jats:sup>+</jats:sup> and CD309<jats:sup>+</jats:sup>/CD34<jats:sup>+</jats:sup> cMVs were inversely correlated with HbA1c (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>‐</mml:mo><mml:mn>0.437</mml:mn></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>‐</mml:mo><mml:mn>0.515</mml:mn></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>‐</mml:mo><mml:mn>0.575</mml:mn></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>‐</mml:mo><mml:mn>0.529</mml:mn></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mtext>r</mml:mtext><mml:mo>=</mml:mo><mml:mo>‐</mml:mo><mml:mn>0.416</mml:mn></mml:math>, and <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mo>‐</mml:mo><mml:mn>0.445</mml:mn></mml:math>, respectively; all <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"><mml:mi>p</mml:mi><mml:mo>≤</mml:mo><mml:mn>0.01</mml:mn></mml:math>), however, only at inclusion. No significant correlations with cardiovascular risk factors were observed. <jats:italic>Conclusions</jats:italic>. Children/adolescents with type 1 diabetes show similar levels of AV<jats:sup>+</jats:sup> cMVs as healthy controls and limited associations with glucose control. This indicates that our young diabetics on intensive insulin treatment have preserved vascular homeostasis and absence of procoagulant cMVs.</jats:p>