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World J Diabetes. Jun 15, 2021; 12(6): 810-826
Published online Jun 15, 2021. doi: 10.4239/wjd.v12.i6.810
Endothelial impairment evaluation by peripheral arterial tonometry in pediatric endocrinopathies: A narrative review
Alberto La Valle, Marco Crocco, Decimo Silvio Chiarenza, Mohamad Maghnie, Giuseppe d'Annunzio
Alberto La Valle, Marco Crocco, Decimo Silvio Chiarenza, Mohamad Maghnie, Giuseppe d'Annunzio, Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Genoa16147, Italy
Alberto La Valle, Marco Crocco, Decimo Silvio Chiarenza, Mohamad Maghnie, Pediatric Clinic and Endocrinology, IRCCS Giannina Gaslini Institute, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, Genoa16147, Italy
Author contributions: La Valle A, Crocco M, Chiarenza DS, d’Annunzio G searched the literature and drafted the manuscript; Maghnie M and d’Annunzio G revised the manuscript, provided further comments and editing.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe d'Annunzio, MD, Adjunct Professor, Medical Assistant, Pediatric Clinic and Endocrinology, IRCCS Istituto Giannina Gaslini, Via Gaslini 5, Genoa 16147, Italy. giuseppedannunzio@gaslini.org
Received: January 29, 2021
Peer-review started: January 30, 2021
First decision: March 16, 2021
Revised: March 30, 2021
Accepted: May 15, 2021
Article in press: May 15, 2021
Published online: June 15, 2021
Processing time: 126 Days and 3.2 Hours
Abstract

Endothelial dysfunction (ED) is characterized by an imbalance between vasodilator and vasoconstriction agents. Several pathological conditions clinically diagnosed in childhood and adolescence are characterized by ED and increased risk for early development of microangiopathic and macroangiopathic impairment, in particular type 1 diabetes mellitus (T1DM), T2DM, obesity, metabolic syndromeand pituitary dysfunction associated to various endocrinopathies. More recently insulin resistance following chemotherapy or radiotherapy for tumors, bone marrow transplantation for hematological malignancies (i.e., cancer survivors), or immunosuppressive treatment for solid organ transplantation has been observed. Assessment of ED by means of non-invasive techniques is the gold standard for early ED detection before clinical manifestation. It is aimed to recognize patients at risk and to avoid the development and progression of more serious illnesses. Reactive hyperemia-peripheral artery tonometry is a noninvasive technique to assess peripheral endothelial function by measuring modifications in digital pulse volume during reactive hyperemia, and represents a non-invasive, reproducible and operator-independent tool able to detect precocious ED. This narrative review aimed to provide an overview of the most important papers regarding ED detection by EndoPat 2000 in children and adolescents with different endocrine diseases. A comprehensive search of English language articles was performed in the MEDLINE database without using other search filters except the publication interval between 2005 and 2020.

Keywords: Pediatric diabetes mellitus, Pediatric endocrinopathies, Metabolic syndrome, Cancer survivors, Endothelial dysfunction, Peripheral artery tonometry

Core Tip: This narrative review highlights the use of a non-invasive, reproducible and non-operator dependent tool aimed to precocious detection of endothelial dysfunctionin pediatric patients affected by several endocrine diseases, characterized by the risk of vascular impairment. The review also reports a summary of the most important published papers related to the topic.