OBJECTIVE -To compare the carotid artery intima-media thickness in Hispanic pediatric type 1 diabetic patients against that in healthy control subjects matched for age, sex, height, and BMI.RESEARCH DESIGN AND METHODS -The evaluation consisted of anthropometric measurements, biochemical parameters, and a carotid Doppler and real-time ultrasound, in which carotid artery intima-media thickness (cIMT), peak systolic velocity, and end diastolic velocity were measured using standardized procedures.RESULTS -A total of 52 diabetic patients and 47 control subjects were included. No significant differences existed in the characteristics between case and control subjects (mean age 11.8 Ϯ 3.1 vs. 11.8 Ϯ 2.8 years, weight 42.2 Ϯ 15.3 vs. 44.2 Ϯ 14.4 kg, height 1.45 Ϯ 0.15 vs. 1.47 Ϯ 0.15 m, BMI 19.3 Ϯ 3.2 vs. 19.9 Ϯ 4.4 kg/m 2 , systolic blood pressure 99.1 Ϯ 9.9 vs. 99.6 Ϯ 9 mmHg, and diastolic blood pressure 63 Ϯ 6.4 vs. 62.0 Ϯ 5.7 mmHg, respectively). The mean duration of diabetes was 4.8 Ϯ 3.2 years (range 6 -144 months), and the mean A1C was 8.6 Ϯ 1.6%. A significantly higher cIMT was found in the patients with type 1 diabetes (0.463 Ϯ 0.04 vs. 0.441 Ϯ 0.04 mm; P ϭ 0.001). In contrast, both peak systolic velocity (107.1 Ϯ 22.8 vs. 119.3 Ϯ 19.2, P Ͻ 0.005) and end diastolic velocity (28.4 Ϯ 6.0 vs. 33.0 Ϯ 7.0, P Ͻ 0.001) were higher in the control subjects.CONCLUSIONS -Type 1 diabetes is associated with higher cIMT and decreased flow velocities in a Hispanic pediatric population.
Diabetes Care 30:2599-2602, 2007A therosclerosis is a long-term process that begins early in life. During childhood, potentially reversible lesions have been shown in autopsy studies and in animal models; lesions progress during the first decade of life and become symptomatic usually after the fourth decade of life (1). Long-term follow-up studies have proven the importance of several cardiovascular risk factors during childhood. Their presence increased the likelihood for having cardiovascular complications in adult life (2). The association between type 1 diabetes and coronary heart disease (CHD) has become undisputed during recent years (3,4). It has been demonstrated that there is a dramatic increase in the morbidity and mortality risk caused by atherosclerotic cardiovascular disease in young adults with type 1 diabetes compared with the nondiabetic population (5,6). Carotid artery intima-media thickness (cIMT) is a prognostic factor for having cardiovascular disease in adults with type 1 diabetes.Recommendations for primary CHD prevention applicable to patients with type 1 and 2 diabetes were published recently (7). There is a growing interest to prevent the cardiovascular disease risk factors early in the course of the disease, even at pediatric stages (8). It is necessary to identify children with type 1 diabetes with the highest risk for CHD using objective and noninvasive studies; if clinically useful information is obtained from its use, it may help to establish additional measures for prevention.Advances in imaging techniques identif...