Key result
In children and adolescents with type 1 diabetes mellitus, mean carotid intima media thickness z-scores increased significantly by 0.58 over 4 years, with systolic blood pressure and BMI as significant predictors of progression.
Observational (n=70)
Single-blind
No
Absolute Event Rate: 2.44% vs 1.86%
p-value: p=<0.001
In children and adolescents with type 1 diabetes, subclinical atherosclerosis progresses over time, and this progression is significantly associated with modifiable risk factors like systolic blood pressure and BMI.
Supports SBP and BMI monitoring in youth with type 1 diabetes; hypothesis-generating for intervention trials on atherosclerosis progression.
BACKGROUND: Type 1 diabetes mellitus is a generally accepted atherogenic risk factor. The aim of this prospective longitudinal study was to evaluate changes in carotid intima media thickness (cIMT) in children and adolescents with type 1 diabetes mellitus (T1DM) using standardized methods. METHODS: We re-evaluated cIMT in 70 (38 f) of initial 150 (80 f) patients with T1DM after 4 years. At re-evaluation, mean (±SD) age was 16.45±2.59 y, mean diabetes duration was 9.2±3.24 y and patients had a mean HbA1c of 8.14±1.06%. RESULTS: Mean cIMT z-scores increased significantly during 4 years (0.58±0.75, p<0.001) as well as BMI-z-score (0.41±0.81, p<0.01), systolic blood pressure (0.77±1.15, p<0.01) and HbA1c (0.90±1.07, <0.001). In a linear regression model systolic blood pressure z-score at first measurement (0.02, CI: 0.01, 0.04) was a significant predictor for the mean effect on cIMT z-score. In a logistic regression model significant risk factors for an increase in IMT of ≥1.5 z-scores were BMI z-scores (OR: 3.02, CI:1.11, 10.14), diabetes duration (OR:1.32, CI:1.04, 1.77) and systolic blood pressure (OR: 1.14, CI: 1.04, 1.27) at first measurement each. CONCLUSIONS: Longitudinal cIMT measurements revealed progression in subclinical atherosclerosis during a four year period in diabetic children and adolescents. Systolic blood pressure and BMI were related to cIMT increment. Control of these risk factors by lifestyle and medical intervention may prevent progression of cIMT in diabetic children.
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Pozza et al. (2011) conducted an observational in Type 1 diabetes mellitus (n=70). Observation vs. Baseline was evaluated on Mean carotid intima media thickness (cIMT) z-score (p=<0.001). In children and adolescents with type 1 diabetes mellitus, mean carotid intima media thickness z-scores increased significantly by 0.58 over 4 years, with systolic blood pressure and BMI as significant predictors of progression.
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