Key result
Type 2 diabetes in overweight and obese adolescents was associated with significantly higher carotid intima-media thickness compared to healthy matched controls (0.68 vs 0.58; p<0.01).
Case-Control
Overweight and obese adolescents with type 2 diabetes exhibit increased carotid intima-media thickness, an early marker of atherosclerosis, which correlates with poor glycemic control and other cardiovascular risk factors.
May warrant vascular monitoring in obese adolescents with T2D; leaves open longitudinal confirmation and intervention effects.
OBJECTIVE: To identify the clinical parameters associated with increased carotid intima-media thickness (CIMT) in overweight and obese adolescents with type 2 diabetes. METHODS: We studied 27 patients (11 males) with type 2 diabetes. Criteria for selection were age (12-19 years), body mass index above the 95th percentile for age and gender, a positive family history of diabetes, normal or high C-peptide, and negative studies for islet cell antibodies. Age- and gender-matched healthy subjects were selected as the control group. Measurements of CIMT, lipid profile, hypersensitive C-reactive protein, hemoglobin A1C (HbA1C), and insulin resistance by homeostasis model of assessment (HOMA) were obtained for all participants. RESULTS: CIMT was higher in diabetic patients than in healthy subjects (0.68 ± 0.16 vs. 0.58 ± 0.1, p < 0.01). The range of HbA1C in the 15 patients with uncontrolled diabetes was 7.6-10.4 (mean: 8.9 ± 0.9). CIMT, HbA1C, systolic blood pressure, triglycerides, HOMA, and C-reactive protein were significantly higher in patients with uncontrolled than with controlled diabetes. In diabetic patients, CIMT correlated positively with body mass index (p < 0.001), duration of diabetes (p < 0.001), systolic (p < 0.001) and diastolic blood pressure (p < 0.01), HbA1C (p < 0.001), HOMA (p < 0.01), and C-reactive protein (p < 0.01). CONCLUSIONS: CIMT is increased in adolescents with type 2 diabetes. Poor glycemic control, HOMA, increased C-reactive protein, body mass index, duration of diabetes, and elevated blood pressure are associated with early atherosclerosis in these patients.
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Kotb et al. (2011) conducted a case-control in Type 2 diabetes in overweight and obese adolescents. Type 2 diabetes vs. Healthy subjects was evaluated on Carotid intima-media thickness (CIMT) (p=<0.01). Type 2 diabetes in overweight and obese adolescents was associated with significantly higher carotid intima-media thickness compared to healthy matched controls (0.68 vs 0.58; p<0.01).
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