Cardiovascular Risk Prediction by the American Diabetes Association Risk-Assessment Tool and Novel and Traditional Cardiovascular Risk Factors in Young Adults With Type 1 Diabetes

Abstract

Introduction: Cardiovascular disease is an important cause of morbidity and mortality in individuals with type 1 diabetes (T1D). The American Diabetes Association (ADA) has the ADA risk-assessment tool for cardiovascular risk (CVR) prediction in individuals with T1D. This study aims to evaluate the prevalence of novel and traditional cardiovascular risk factors (CVRF) and the CVR by the ADA risk-assessment tool: 10year risk for diabetes complications in young adults with T1D.Methods: Cross-sectional observational study of T1D individuals aged 18-40 years and T1D duration ≥1 year. The ADA risk-assessment tool was applied to predict CVR.Results: 75 individuals, 61.3% male, with a median age of 30 (26.0-36.0) and 13.0 (6.0-20.0) years of T1D duration. Hypertension was found in 16% of individuals and dyslipidemia in 75.0%. 21.3% were active smokers, 30.7% sedentary, and 42.7% were at least overweight. Most individuals had a 10-year risk <1% for all complications except myocardial infarction (MI). In individuals who were outside the honeymoon period (T1D duration ≥ 5 years), most had a 10-year risk <1% for all complications except MI and amputation. Nontraditional CVRF homocysteine, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, magnesium, and vitamin D correlated with the ADA risk-assessment tool. 10-year risk for MI ≥1% was significantly more frequent in men. Conclusion:To our knowledge, this is the first study to apply the ADA risk-assessment tool: 10-year risk for diabetes complications in T1D. Young adults with T1D have a worrying prevalence of CVRF and show suboptimal control. Most individuals with T1D duration ≥1 year have an estimated 10-year risk <1% for all complications, except for MI.Categories: Cardiology, Endocrinology/Diabetes/Metabolism, Preventive Medicine Keywords: cardiovascular risk (cvr), myocardial infarction (mi), cardiovascular disease, american diabetes association risk-assessment tool: 10-year risk for diabetes complications, cardiovascular risk factor, traditional cardiovascular risk factors, novel cardiovascular risk factors, young adult, cardiovascular risk assessment, type 1 diabetes mellitus (t1d)

The Influence of Body Fat and Lean Mass on HbA1c and Lipid Profile in Children and Adolescents with Type 1 Diabetes Mellitus

“…Several myokines have positive effects on glucose uptake and improvement in blood glucose. On the other hand, the pro-inflammatory scenario promoted by the reduction in the release of these myokines that, associated with poor glycemic control, leads to an increased risk of developing metabolic syndrome and cardiovascular complications [ 23 , 47 , 48 , 49 ].…”

“…Thus, alterations in these molecules can interfere with the glycemic control in DM1 and the proportion of adipose tissue. Studies show that lower levels of apo A or higher levels of apo B are correlated with signs of microvascular dysfunction, which are related to DM1 complications, such as the pathogenesis of diabetic retinopathy [ 22 , 23 , 24 , 25 ].…”

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