This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Cardiovascular disease is the leading cause of death worldwide and Type 2 diabetes mellitus T2DM increases the risk of death from cardiovascular disease CVD by 5 to 7 times. The CVD risk in pre-diabetes remains elevated in the large percentage of patients who never go on to develop type 2 diabetes. Recent data with regards to pre-diabetes have been generated from adult research studies, the growing pediatric obesity epidemic and increasing incidence of type 2 diabetes in children necessitates research aimed at identifying children at risk for developing CVD early in life. Recent adult data have demonstrated that the highest CVD risk amongst pre-diabetes subjects may be in those with IFG.We hypothesize that pediatric patients with IFG have more vascular dysfunction than sex-, race-, and body mass index BMI matched patients with normal glucose metabolism NGM. Radial artery tonometry and reactive hyperemia peripheral artery tonometry RH-PAT are two noninvasive surrogate measurements of arterial stiffness and endothelial function that have been used to predict future CVD in adults and have been used to demonstrate abnormalities in other pediatric populations with elevated CVD risk. We will obtain radial tonometry and RH-PAT measurements in patients 10-18 years of age with IFG and in sex-, race-, and BMI-matched controls with NGM. Documentation of increased arterial stiffness and endothelial dysfunction in children with IFG will support aggressive intervention in pediatric populations with IFG to prevent morbidity and mortality associated with CVD.
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