Influence of a family history of type 2 diabetes, demographic and clinical data on carotid intima-media thickness in patients with type 1 diabetes: a cross-sectional study

Abstract

BackgroundIntima-media thickness (IMT) of the common carotid artery is a surrogate end point of cardiovascular disease (CVD). Identifying the factors associated with a higher IMT may contribute to the identification of subjects with higher CVD risk. Our objective was to compare the common carotid IMT of type 1 diabetes patients to healthy control subjects. The secondary objective was to determine factors associated with a higher carotid IMT.MethodsWe conducted a cross-sectional study between March 2009 and October 2013, comprising 127 type 1 diabetes patients and 125 control subjects matched by age, gender and body mass index (BMI). Carotid IMT was measured using semi-automated edge detection software.ResultsType 1 diabetes patients had a higher median IMT compared with control subjects (0.538; IQR: 0.500-0.607 vs 0.513 mm; IQR: 0.481-0.557, respectively p = 0.001). Women with type 1 diabetes had a higher median IMT difference compared to the control group (0.537; IQR: 0.495-0.596 vs 0.502 mm; IQR: 0.472-0.543, respectively p = 0.003) than did men with type 1 diabetes (0.547; IQR: 0.504-0.613 vs 0.528 mm; IQR: 0.492-0.575, respectively p = 0.2). Age and diabetes duration had an additive effect on the IMT of type 1 diabetes patients. Multivariate gamma regression model analysis showed that in type 1 diabetes patients, the IMT was associated with age (Exp (β) = 1.006, p < 0.001), duration of diabetes (Exp (β) = 1.004, p = 0.001), BMI (Exp (β) = 1.005, p = 0.021), family history of type 2 diabetes (Exp (β) = 1.044, p = 0.033), total cholesterol (Exp (β) = 0.999, p = 0.001) and creatinine clearance (Exp (β) = 1.000, p = 0.043).ConclusionsPatients with type 1 diabetes have increased IMT, a marker of subclinical atherosclerosis. The CVD risk may be similar between men and women with type 1 diabetes, suggesting a loss of gender protection. Also, CVD risk may be higher in those with a family history of type 2 diabetes. Prospective studies are needed to confirm the predictive value of these findings and the causal effect between IMT and CVD in patients with type 1 diabetes.

Increased carotid intima-media thickness in Brazilian adolescents with type 1 diabetes mellitus

“…It was recently reported in patients with DM1 of long duration there was a 0.4% increase in IMT for each year of disease duration [37], as we were also able to demonstrate. Age and diabetes duration had an additive effect on the IMT of DM1 patients.…”

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

“…Clinical trials have shown that diastolic blood pressure in the highest quintile, even without the added risks of high cholesterol and smoking, still contributes significantly to the risk of atherosclerosis (35,36). Our data corroborate this knowledge, as hypertension correlated positively with CIMT and carotid plaques and was more frequently diagnosed in patients with carotid obstruction.…”

“…This finding contrasts with previous studies that have demonstrated that CIMT increases with the duration of type 1 DM (19,20,36). In these studies, the duration of the disease was shorter than that in our study, which might explain our findings.…”

“…Laboratory inflammation markers have been used as predictive tools for atherosclerosis in patients with type 2 DM (36,(40)(41)(42)(43). In our study, we found no association between the inflammation markers hs-PCR and fibrinogen with subclinical atherosclerosis in patients with type 1 DM.…”

“…There are controversies in the literature regarding the association of age and CIMT, in which positive (20,36) and negative (19) results have been reported, but none of these studies have evaluated the presence of carotid plaques.…”