Lifestyle risk factors for atherosclerosis in adults with type 1 diabetes

Abstract

The objective of this study was to compare the amount of self-reported physical activity, alcohol and tobacco use in a large sample of adults with type 1 diabetes and non-diabetic subjects. A second aim is to test the hypothesis that these lifestyle risk factors are associated cross-sectionally with coronary artery calcification. In 2000-2002, the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study applied validated questionnaires for smoking, alcohol and physical activity to 582 type 1 diabetes subjects and 724 non-diabetic subjects. More type 1 diabetes subjects reported current smoking than non-diabetic subjects (12.3% versus 8.6%, p50.027). Overall, reported physical activity did not differ by diabetes status (p50.79). More type 1 diabetes subjects reported never having consumed alcohol (10% versus 4%, p<0.0001) and those who drank consumed less alcohol (p50.0015) than non-diabetic subjects. Physical activity and smoking were significantly associated with the presence of coronary artery calcification (adjusted OR50.9, 95% CI: 0.8-0.996, p50.045, and OR51.7, CI: 1.1-2.6, p50.03, respectively). Type 1 diabetes was independently associated with increased odds of coronary artery calcification (OR53.5, 95% CI: 2.5-5.0, p<0.0001). Differences exist in lifestyle-related cardiovascular risk factors in men and women with type 1 diabetes compared with non-diabetic subjects in the CACTI study.Keywords diabetes, cardiovascular disease, physical activity, smoking, alcohol factors in a large cohort of young adults with type 1 diabetes compared with non-diabetic subjects. A second aim is to test the hypothesis that these lifestyle factors are associated crosssectionally with coronary artery calcification (CAC), a marker of subclinical coronary artery atherosclerosis.

Diet, Lifestyle and Chronic Complications in Type 1 Diabetic Patients

“…Of the eight studies that reported an association between physical activity and CVD there were five cross-sectional studies (Kriska AM et al 1991;Herbst A et al 2007;Valerio G et al 2007;Bishop et al 2009;Trigona B et al 2010) and three trials (Lehmann R et al 1997;Fuchsjäger-Mayrl G et al 2002;Seeger JPH et al 2011). No prospective cohort studies were found.…”

“…Impaired endothelial function is considered as an early sign of atherosclerosis, which is often the underlying cause of CVD. And finally, (Bishop et al 2009) a significant inverse association between physical activity and CAC, a marker of coronary artery atherosclerosis, was demonstrated. In conclusion all these studies found a beneficial effect of physical activity on cardiovascular risk factors.…”

“…Alcohol has favourable effects on HDL-cholesterol, inflammation and inhibition of platelet aggregation (Beulens et al 2008). Because of this favourable effects we expect a beneficial effect on CVD, however to date no association was found between alcohol and CVD in type 1 diabetes patients (Bishop et al 2009). In this cross-sectional study, markers for CVD were used instead of CVD as endpoint.…”

“…One cross-sectional study (Bishop et al 2009) reported findings on the association between alcohol and cardiovascular disease. No significant association was found between alcohol consumption (±13.8 drinks/month) and CAC, a marker of coronary artery atherosclerosis (adjusted OR=0.9, 95% CI: 0.8-1.1, p=0.15).…”

“…Only Strychar et al (Strychar I et al 2009) and Georgopoulos et al (Georgopoulos A et al 2000) performed a randomized controlled trial. One study reported an association between lifestyle risk factors (including alcohol) and atherosclerosis, which is often the underlying cause of CVD (Bishop et al 2009). Eight studies reported an association between physical activity and CVD risk factors (Kriska AM et al 1991;Lehmann R et al 1997;Fuchsjäger-Mayrl G et al 2002;Herbst A et al 2007;Valerio G et al 2007;Bishop et al 2009;Trigona B et al 2010;Seeger JPH et al 2011), and two studies reported an association with dietary patterns (Gunther ALB et al 2008;Liese AD et al 2011).…”