This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The prevalence of type 2 diabetes mellitus has increased dramatically in adolescents. This appears to be a direct result of the increase in prevalence and severity of obesity in the pediatric population. In adults with type 2 diabetes, the risk for cardiovascular disease is quite high. It is not known if adolescents with type 2 diabetes have an equivalent high level of risk of CVD. If they do then it would be expected that they would develop clinical CVD in their late 20's or 30's. This would have important clinical implications and would suggest the need for very aggressive management of CVD risk factors and diabetes. This study is a cross-sectional evaluation of cardiac and vascular structure and function in a population of 300 adolescents with type 2 diabetes compared to an obese control group of 300 and a normal weight control group of 300 who have been matched by age, sex and race. Assessment of CVD development will be accomplished using novel non invasive imaging methods including echocardiographic measurement of cardiac structure and function, ultrasound evaluation of carotid intimal-medial thickness, central aortic pressure and augmentation index will be accomplished using the SphygomoCor Pulse Wave Analysis System and evaluation of endothelial function by brachial artery reactivity. The results of this study will fill an important gap in knowledge, will serve as the baseline for future longitudinal studies and may provide the basis for clinical strategies to prevent the development of CVD in young patients with type 2 diabetes.
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