Biomarkers of fatty acid intake are independently associated with preclinical atherosclerosis in individuals with type 1 diabetes

Abstract

Purpose Information on the association between diet and cardiovascular disease (CVD) in type 1 diabetes (T1D) is scarce. We assessed the association between biomarkers of fatty acid (FA) intake and the presence of carotid plaques (a surrogate marker of future CVD events) in this high-risk population. Methods Cross-sectional study in 167 consecutive T1D patients without CVD and with at least one of the following: ≥ 40 years, diabetic nephropathy, or ≥ 10 years of T1D duration with another CVD risk factor. The FA profile of erythrocyte membranes was determined by gas chromatography, and the number of carotid plaques (intima-media thickness ≥ 1.5 mm) was assessed by ultrasonography. Regression models were constructed adjusting for classical (age, gender, blood pressure, smoking habit, LDL-cholesterol, body mass index and statins) and T1D-specific risk factors (diabetes duration, HbA1c and chronic complications). Results A total of 58.7% were men (mean age 48.3 ± 10.3 years, T1D duration 27.2 ± 10.1 years). Sixty-one patients (36.5%) showed carotid plaque. Linoleic acid decreased and all-C18:1trans increased with the number of carotid plaques (none, 1-2, ≥ 3 plaques; p for trend < 0.05). In multivariate regression models, linoleic acid remained inversely associated with the presence of plaque [1% increase of total FAs; OR 0.71 (0.53-0.95), p = 0.021] and ≥ 2 plaques [OR 0.70 (0.51-0.98), p = 0.039]; whereas, all-C18:1trans was positively associated with ≥ 3 plaques (0.1% increase of total FAs; OR 1.51 [1.05-2.16], p = 0.026). Conclusions Erythrocyte FA composition, as a biomarker of FA intake, was independently associated with preclinical atherosclerosis in T1DM. Our data support the potential role of an unfavorable pattern of fat intake and CVD risk in this population.

Nuclear Magnetic Resonance-Based Lipidomics in the Assessment of Cardiometabolic Risk in Type 1 Diabetes: An Exploratory Analysis

“…Our results are aligned with three recent meta-analyses in the general population; these include several biomarkers of dietary linoleic acid intake (adipose tissue and blood) and report a strong association of this fatty acid with CVD protection [43][44][45]. In this regard, our study group has also shown that this lipid species (assessed through means of gas chromatography) was inversely associated with the prevalence of symptomatic carotid artery disease in the general population [46], as well as with carotid atherosclerosis burden among the T1D population [11]. These previous and our actual findings concur with the recommendations released by the American Heart Association (AHA) to replace foods rich in saturated fatty acids with those rich in x-6 fatty acids to decrease CVD risk [47], not only for the general population but also for high-risk populations such as patients with T1D.…”

“…Lipidomic analysis is a new technique that identifies a broad range of lipid species, which could uncover some variables potentially associated with chronic complications in this population [10]. Preliminary data from our group also showed that some dietary-related lipid parameters could identify individuals with T1D more prone to suffer from CVD [11,12]. However, the information regarding lipidomic-related variables with preclinical atherosclerosis, especially in Mediterranean countries, is scarce.…”

Severe hypoglycemia and hypoglycemia awareness are associated with preclinical atherosclerosis in patients with type 1 diabetes without an estimated high cardiovascular risk

“…Bilateral carotid artery ultrasound images were acquired using high‐resolution B‐mode ultrasound ( Acuson X700 [Siemens Healthineers] and Aplio a450 [Canon]) with the same electric linear array 5–10 MHz transducer. Predefined and standardised imaging protocols to evaluate carotid intima‐media thickness (IMT) and the presence of plaques were carried out as described previously 23,24 . Carotid images visualised using B‐mode and colour Doppler in both longitudinal and transverse planes to evaluate the presence of circumferential asymmetry.…”

“…Predefined and standardised imaging protocols to evaluate carotid intima-media thickness (IMT) and the presence of plaques were carried out as described previously. 23,24 Carotid images visualised using B-mode and colour Doppler in both longitudinal and transverse planes to evaluate the presence of circumferential asymmetry. Carotid plaques were defined as focal echostructures encroaching into the arterial lumen by at least 50% of the surrounding IMT value or when IMT was at least 1.5 mm as measured from the media adventitia interface to the intima-lumen surface.…”