Age of Onset of Type 1 Diabetes in Children and Carotid Intima Medial Thickness

Abstract

The IMT measurement detected subclinical atherosclerosis in a large cohort of diabetic children. Systolic blood pressure, total cholesterol level, insulin dosage, and age at onset of the disease were significantly related to the IMT. Longitudinal measurements may help to identify patients at special risk for atherosclerotic changes and cardiovascular disease.

Do traditional cardiovascular risk factors solely explain intima-media thickening in youth with type 1 diabetes?

“…These results are consistent with some previous studies (Dalla Pozza et al, 2007;Krantz et al, 2004;Schwab et al, 2007), but not with other studies (EDIC, 1999;Margeirsdottir et al, 2010). In our age-specific analysis of cIMT, we found that median cIMT was significantly and equally greater in children and adolescents with type 1 diabetes when compared with controls across all age categories.…”

“…The lack of a clear contribution of classical CVD risk factors to cIMT in our study and in previously published pediatric studies (Dalla Pozza et al, 2007;Dalla Pozza et al, 2011;Krantz et al, 2004;Krebs et al, 2012) may be explained by differences in age, diabetes duration, length of follow-up, and CVD risk categorization (current vs. historical data). Alternatively, the interplay between adult classical CVD risk factors may change over time and/or may contribute in a more complex way to the vascular changes and cIMT increase seen in type 1 diabetes.…”

“…However, it should be noted that the relationship with age was studied cross-sectionally instead of longitudinally; previous studies, that were cross-sectional as well, were also not consistent with respect to the effect of age on cIMT. Dalla Pozza et al (2007) found an association between age and cIMT in young patients with type 1 diabetes, whereas Margeirsdottir et al (2010) only found this for the first three age quartiles in young patients with type 1 diabetes. Jourdan et al (2005) found only a slight increase of cIMT with age in controls.…”

“…However, in this group conflicting results on cIMT were observed when patients were compared with healthy controls (Dalla Pozza et al, 2007;Krantz et al, 2004;Margeirsdottir et al, 2010;Schwab et al, 2007). Little is known about age-specific differences in cIMT.…”

“…Studies on the impact of covariables associated with increased cIMT in children and adolescents with type 1 diabetes are contradictory. One study found that cIMT was significantly associated with body mass index (BMI) and duration of diabetes (Dalla Pozza et al, 2011), whereas another study found that age at diabetes onset, insulin dose, and total cholesterol level correlated with cIMT (Dalla Pozza et al, 2007); systolic blood pressure (SBP) was the only factor found to be predictive in both studies (Dalla Pozza et al, 2007. In addition, Krantz et al (2004) pointed to gender-specific differences in cIMT, with the high-density lipoprotein cholesterol (HDL-C)/low-density lipoprotein cholesterol (LDL-C) ratio being a significant factor in males, but not females whereas Krebs et al (2012) reported that diabetes duration and pulse pressure were significant factors in males, and LDL-C, glycated hemoglobin (HbA 1c ), and duration of diabetes were significant in females.…”