Arterial Stiffness and Heart Rate Variability Help Identify Cardiovascular Risk in Youth with Type 2 Diabetes

Published July 2020 | Journal of Diabetes and its Complications

When a child is diagnosed with type 2 diabetes (T2D), their risk for cardiovascular disease increases; however, some are at higher risk than others. How can providers identify these patients to improve outcomes?  A link between two early cardiovascular markers could provide important clues.

Research led by first author Amy Shah, MD, MS, Division of Endocrinology, in collaboration with Elaine Urbina, MD, MS, director of Preventive Cardiology, discovered a relationship between increased artery stiffness and lower heart rate variability (HRV) in patients with T2D, resulting in a worse cardiovascular risk profile.

Using data from the SEARCH for Diabetes in Youth study, researchers examined characteristics of 185 young adults with youth-onset T2D. Cardiovascular risk factors and heart rate variability were compared between those with and without arterial stiffness. The team’s findings highlighted distinct differences between the two groups. Participants with T2D and arterial stiffness were more likely to be more overweight, have higher blood pressure, and higher cholesterol. Stiffer arteries were also associated with abnormalities in heart rate variability.

Measurements of the arteries are noninvasive tests that predict future risk for morbidity and mortality in cardiovascular disease. These findings show that arterial stiffness and heart rate variability in youth with T2D are key indicators of risk that could help steer early interventions.

“These findings stress that teens are showing early markers of cardiovascular disease,” says lead author Shah. “What we need to do now is understand why some teens with obesity develop T2D, and whether treating blood pressure and cholesterol early and aggressively can prevent future diabetes-related complications.”

While the SEARCH study has stopped collecting prospective data, researchers will continue utilizing previous data and blood samples collected over 20 years to examine complications of diabetes emerging in young adulthood.

Locations of SEARCH for Diabetes in Youth Study Sites