What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Type 1 diabetes (n=252). Intervention: Type 1 diabetes vs. Healthy control subjects. Primary outcome: Common carotid intima-media thickness (IMT) (p=0.001).

What question did this study set out to answer?

To evaluate common carotid artery intima-media thickness in patients with type 1 diabetes compared to healthy controls and identify clinical variables linked to elevated vascular thickness.

May 3, 2014Cardiovascular DiabetologyOpen Access

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

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Key result

Patients with type 1 diabetes had a significantly higher median carotid intima-media thickness compared to healthy control subjects (0.538 mm vs 0.513 mm, p=0.001).

Why the study?

Does type 1 diabetes increase carotid intima-media thickness compared to healthy controls?

Population

127 patients with type 1 diabetes and 125 healthy control subjects matched by age, gender, and BMI.

Comparison

Type 1 diabetes (observational) vs Healthy control subjects

Design

Cross-sectional, IMT measured off-line by two independent skilled examiners…

Authors

CACarlos Roberto Moraes de AndradeUniversidade Federal Fluminense ESEliete Leão Clemente SilvaUniversidade do Estado do Rio de Janeiro MMMaria de Fátima Bevilaqua da MattaUniversidade do Estado do Rio de Janeiro

Discussion

Member takes

Implication

Indicates need for heightened cardiovascular vigilance in type 1 diabetes; leaves open prognostic value pending longitudinal studies.

Key Points

To evaluate common carotid artery intima-media thickness in patients with type 1 diabetes compared to healthy controls and identify clinical variables linked to elevated vascular thickness.
Conducted a cross-sectional study from March 2009 to October 2013 comparing 127 patients with type 1 diabetes to 125 control subjects matched for age, sex, and body mass index.
Assessed carotid intima-media thickness via semi-automated edge detection ultrasound software and modeled independent determinants using multivariate gamma regression.
Patients with type 1 diabetes exhibited significantly greater median carotid intima-media thickness than controls (0.538 mm [IQR: 0.500–0.607] vs 0.513 mm [IQR: 0.481–0.557], p = 0.001).
Women with type 1 diabetes showed a significant difference in thickness versus controls (0.537 mm [IQR: 0.495–0.596] vs 0.502 mm [IQR: 0.472–0.543], p = 0.003), whereas men did not show a statistically significant difference (p = 0.2).
Multivariate gamma regression associated carotid thickness with age (Exp(β) = 1.006, p < 0.001), diabetes duration (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).

Study Design

Type

Cross-Sectional (n=252)

Multicenter

Structured PICO

Does type 1 diabetes increase carotid intima-media thickness compared to healthy controls?

Population

127 patients with type 1 diabetes (older than 10 years, diabetes duration >5 years, continuous insulin use) and 125 healthy control subjects matched by age, gender, and BMI.

Intervention

Type 1 diabetes (observational)

Comparator

Healthy control subjects

Outcome

Common carotid intima-media thickness (IMT)surrogate

Main Result

Absolute Event Rate: 0.538% vs 0.513%

p-value: p=0.001

Patients with type 1 diabetes have increased carotid intima-media thickness compared to healthy controls, with women losing their gender protection and family history of type 2 diabetes further increasing cardiovascular risk.

Limitations

Single center study with only internal validation
Cross-sectional design precludes the inference of cause-effect relationships
Cross-sectional design cannot confirm causal effect
Single center study
Difficulty finding older healthy control subjects

Cite This Study

Andrade et al. (2014) conducted a cross-sectional in Type 1 diabetes (n=252). Type 1 diabetes vs. Healthy control subjects was evaluated on Common carotid intima-media thickness (IMT) (p=0.001). Patients with type 1 diabetes had a significantly higher median carotid intima-media thickness compared to healthy control subjects (0.538 mm vs 0.513 mm, p=0.001).

synapsesocial.com/papers/6a1104d548dd349bb91681be https://doi.org/10.1186/1475-2840-13-87

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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

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

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

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider