Undiagnosed coronary artery disease in long-term type 1 diabetes. The Dialong study

Holte, Kari Anne; Svanteson, Mona; Hanssen, Kristian F.; Haig, Ylva; Solheim, Svein; Berg, Tore Julsrud

doi:10.1016/j.jdiacomp.2019.01.006

Cited by 14 publications

(26 citation statements)

References 41 publications

(36 reference statements)

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“…Computed tomography coronary angiography (CTCA) is increasingly employed to detect CVD. A recent study demonstrated a high prevalence of undiagnosed obstructive coronary artery disease in patients with T1DM of long duration, with an association with mean HbA1c [ 81 ]. CTCA can also be used to generate CAC scores.…”

Section: Surrogate Measurements Of Atherosclerosis: Screening and Detmentioning

confidence: 99%

Cardiovascular Risk in Type 1 Diabetes Mellitus

2019

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Type 1 diabetes mellitus (T1DM) is associated with premature cardiovascular disease (CVD), but the underlying mechanisms remain poorly understood. The American Diabetes Association and the European Association for the Study of Diabetes recently updated their position statement on the management of type 2 diabetes mellitus (T2DM) to include additional focus on cardiovascular risk; improved management of risk factors in T1DM is also needed. There are important differences in the pathophysiology of CVD in T1DM and T2DM. Hyperglycaemia appears to have a more profound effect on cardiovascular risk in T1DM than T2DM, and other risk factors appear to cause a synergistic rather than additive effect, so achievement of treatment targets for all recognized risk factors is crucial to reducing cardiovascular risk. Here we discuss the evidence for addressing established cardiovascular risk factors, candidate biomarkers and surrogate measurements, and possible interventions.

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Section: Surrogate Measurements Of Atherosclerosis: Screening and Detmentioning

confidence: 99%

Cardiovascular Risk in Type 1 Diabetes Mellitus

2019

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“…and lower diastolic blood pressure than the control group [4]. Five percent in the diabetes group had no retinopathy.…”

Section: Plos Onementioning

confidence: 65%

“…The accelerated coronary atherosclerosis seen in diabetes is more severe and diffuse than in people without diabetes [1][2][3]. However, some people have normal coronary arteries after 50 years of type 1 diabetes as we have recently reported [4].…”

Section: Introductionmentioning

confidence: 75%

“…CTCA was performed on a Dual Source CT scanner (Somatom Definition Flash, Siemens, Erlangen, Germany), and the details for the investigation have been previously described [4].…”

Section: Discussionmentioning

confidence: 99%

“…All participants had a skin punch biopsy for measurements of collagen-linked AGEs and MetSO, fasting morning blood and urine samples, and retinal photos. The participants without established CHD (n = 88/103 in the diabetes group and n = 60/63 of controls) were referred to CTCA as previously described [4].…”

Section: Methodsmentioning

confidence: 99%

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Collagen methionine sulfoxide and glucuronidine/LW-1 are markers of coronary artery disease in long-term survivors with type 1 diabetes. The Dialong study

et al. 2020

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Objectives Type 1 diabetes is a risk factor for coronary heart disease. The underlying mechanism behind the accelerated atherosclerosis formation is not fully understood but may be related to the formation of oxidation products and advanced glycation end-products (AGEs). We aimed to examine the associations between the collagen oxidation product methionine sulfoxide; the collagen AGEs methylglyoxal hydroimidazolone (MG-H1), glucosepane, pentosidine, glucuronidine/LW-1; and serum receptors for AGE (RAGE) with measures of coronary artery disease in patients with long-term type 1 diabetes. Methods In this cross-sectional study, 99 participants with type 1 diabetes of � 45-year duration and 63 controls without diabetes had either established coronary heart disease (CHD) or underwent Computed Tomography Coronary Angiography (CTCA) measuring total, calcified and soft/mixed plaque volume. Skin collagen methionine sulfoxide and AGEs were measured by liquid chromatography-mass spectrometry and serum sRAGE/esRAGE by ELISA. Results In the diabetes group, low levels of methionine sulfoxide (adjusted for age, sex and mean HbA 1c) were associated with normal coronary arteries, OR 0.48 (95% CI 0.27-0.88). Glucuronidine/LW-1 was associated with established CHD, OR 2.0 (1.16-3.49). MG-H1 and glucuronidine/LW-1 correlated with calcified plaque volume (r = 0.23-0.28, p<0.05), while

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Discoveries from the study of longstanding type 1 diabetes

et al. 2021

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Award programmes that acknowledge the remarkable accomplishments of long-term survivors with type 1 diabetes have naturally evolved into research programmes to determine the factors associated with survivorship and resistance to chronic complications. In this review, we present an overview of the methodological sources of selection bias inherent in survivorship research (selection of those with early-onset diabetes, incidence-prevalence bias and bias from losses to follow-up in cohort studies) and the breadth and depth of literature focusing on this special study population. We focus on the learnings from the study of longstanding type 1 diabetes on discoveries about the natural history of insulin production loss and microvascular complications, and mechanisms associated with them that may in future offer therapeutic targets. We detail descriptive findings about the prevalence of preserved insulin production and resistance to complications, and the putative mechanisms associated with such resistance. To date, findings imply that the following mechanisms exist: strategies to maintain or recover beta cells and their function; activation of specific glycolytic enzymes such as pyruvate kinase M2; modification of AGE production and processing; novel mechanisms for modification of renin-angiotensin-aldosterone system activation, in particular those that may normalise afferent rather than efferent renal arteriolar resistance; and activation and modification of processes such as retinol binding and DNA damage checkpoint proteins. Among the many clinical and public health insights, research into this special study population has identified putative mechanisms that may in future serve as therapeutic targets, knowledge that likely could not have been gained without studying long-term survivors.

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Undiagnosed coronary artery disease in long-term type 1 diabetes. The Dialong study

Cited by 14 publications

References 41 publications

Cardiovascular Risk in Type 1 Diabetes Mellitus

Cardiovascular Risk in Type 1 Diabetes Mellitus

Collagen methionine sulfoxide and glucuronidine/LW-1 are markers of coronary artery disease in long-term survivors with type 1 diabetes. The Dialong study

Discoveries from the study of longstanding type 1 diabetes

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