de Andrade Junior CRM, Silva ELC, da Matta MDFB, Castier MB, Rosa MLG, Gomes MDB. 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.
Cardiovasc Diabetol 2014;
13:87. [PMID:
24886106 PMCID:
PMC4016785 DOI:
10.1186/1475-2840-13-87]
[Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/24/2014] [Indexed: 12/13/2022] Open
Abstract
Background
Intima-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.
Methods
We 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.
Results
Type 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).
Conclusions
Patients 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.
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