Carotid Intima-Media Thickness in Pediatric Type 1 Diabetic Patients

Abstract

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...

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Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…[93][94][95][96][97] Factors associated with this higher cIMT include lower vitamin C levels 98 and longer duration of disease. 99,100 Adolescents with T2DM also demonstrate higher cIMT compared with healthy control subjects, 101,102 with diabetes mellitus duration 103 and glucose control playing a role.…”

Relation between cardiovascular disease risk factors and common carotid artery intima media thickness

“…In addition to the researchers in the literature stating that DM increases carotid IMT, there are also researchers reporting no relation 7,15,16,39,40 . In the present study, univariate analyses demonstrated that DM is among the risk factors eff ective on carotid IMT; whereas, regression analysis revealed no signifi cant eff ect of DM on carotid IMT.…”