Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus

Abstract

Tip 1 diyabetes mellituslu hastalarda karotis intima-media kalınlığı ve komplikasyonlarla ilişkisi ABS TRACT Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy). Methods: One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student's t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis. Results: Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70±0.11 mm) compared with the patients without complications (0.63 ± 0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009). Conclusions: Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM.

Soluble receptor for advanced glycation end products (sRAGE) and carotid intima-media thickness (CIMT) in type 1 diabetes Mellitus: Possible association with diabetic vascular complications

“…This is in agreement with other studies [11]. Others reported no difference in lipid profile between diabetics and controls [12].…”

Carotid intima-media thickness and arterial stiffness in type 1 diabetic patients with and without microangiopathy

“…The EURODIAB Prospective Complications Study supported the evidence for a strong predictive role of albuminuria in the pathogenesis of CVD in type 1 diabetes [4]. A few studies indicated that albumin excretion was associated with subclinical atherosclerosis [17,18]. This study shows that type 1 diabetic patients with microangiopathy have greater CIMT and arterial stiffness than subjects without complications.…”

“…They supported the finding that patients with diabetic retinopathy and nephropathy have increased CIMT in comparison to subjects without chronic complications and there was a positive correlation between the number of complications and CIMT. Moreover, multiple regression analysis demonstrated a significant relationship between CIMT and the presence of microvascular complications [17].…”

Coexisting Large and Small Vessel Disease in Patients with Ischemic Stroke of Undetermined Cause

“…However, the correlation of aortic plaques with the presence of SVD is stronger than might have been expected and has not been described before, although numerous reports about associations of LAA (in the form of carotid atherosclerosis) and SVD are known from pathological (postmortem) studies and described in patients with particular associated risk factors or diseases such as diabetes or vasculitis [2,8,9,10,11,12,13]. Our study demonstrates this association of macro- and microangiopathy in this group of ischemic stroke patients considering large (carotid arteries) and very large vessels (aorta).…”