Abstract
Autoimmune or type 1 diabetes mellitus (T1DM), accounts for 90-95% of all cases of diabetes, while type 2 diabetes mellitus (T2DM), characterized by impaired insulin sensitivity and production, accounts for the other 5-10%. Atherosclerotic process starts during childhood and recognize several mechanisms that are activated in response to noxius stimuli and participate in a complex state which is accepted to be a chronic inflammatory state. T1DM patients, especially those with a non-optimal metabolic control, have a higher risk of developing all macrovascular complications such as myocardial infarction, stroke and silent ischemia. Macrovascular disease is mainly associated with hyperglycemia, dyslipidemia, obesity, hypertension, hypercoagulable state, cigarette smoking, lack of exercise, endothelial dysfunction, hyperhomocysteinemia and vascular wall abnormalities. In this paper we review the importance of traditional and non-traditional risk factors for macrovascular complications in children with T1DM and discuss their role in the pathogenesis of the excess cardiovascular mortality in these patients.
Key words
Type 1 diabetes - cardiovascular disease - hyperglycemia - advanced glycation end-products - lipids - nitric oxide - macroangiopathy
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1445-1453
Correspondence
Francesco ChiarelliM.D., Ph.D.
Department of Pediatrics·University of Chieti
Via dei Vestini 5
66100 Chieti
Italy
Telefon: +39/0871/35 80 15
Fax: +39/0871/57 48 31
eMail: chiarelli@unich.it
