Key result
Type 1 diabetic patients with microangiopathy had significantly higher carotid intima-media thickness (median 0.53 mm vs 0.47 mm, p=0.002) and arterial stiffness compared to those without complications.
Why the study?
Does the presence of microangiopathy correlate with increased carotid intima-media thickness and arterial stiffness in type 1 diabetic patients?
Case-Control (n=87)
No
Does the presence of microangiopathy correlate with increased carotid intima-media thickness and arterial stiffness in type 1 diabetic patients?
Absolute Event Rate: 0.53% vs 0.47%
p-value: p=0.002
In young type 1 diabetic patients, the presence of microangiopathic complications is associated with increased carotid intima-media thickness and arterial stiffness, suggesting a shared pathophysiology between micro- and macrovascular disease.
Microangiopathy may signal higher macrovascular risk in type 1 diabetes; supports shared pathophysiology but remains hypothesis-generating.
The aim of the study was to assess carotid intima-media thickness (CIMT) as a subclinical marker of atherosclerosis and arterial stiffness in type 1 diabetic patients in relation to microangiopathy. Material and methods: We included 87 type 1 diabetic patients (44 women, 43 men), median age 34 years (interquartile range [IQR] 29-43), median disease duration 10 years (IQR: 9-14), mean standard deviation (SD) glycated haemoglobin (HbA 1c ) 8.4 1.4%. Fifty patients had at least one microangiopathic complication. Intima-media thickness (IMT) of the common carotid artery was measured using high resolution ultrasonography. Arterial stiffness was assessed using digital volume pulse analysis and tonometric measurement of wave reflection and central haemodynamics. Results: Subjects with microangiopathy compared with those without had higher values of CIMT (median [IQR]: 0.53 mm [0.45-0.60 mm] vs 0.47 mm [0.34-0.52 mm], p = 0.002), higher central augmentation index (CAI x ) (mean SD: 120.2 19.4% vs. 110.5 17.1%, p = 0.016) and higher peripheral augmentation index (PAI x ) (65.7 18.1% vs. 57.2 14.9%, p = 0.023). In the logistic regression analysis, the duration of diabetes, systolic and diastolic blood pressure, postprandial glycaemia, HbA 1c and triglycerides predicted the presence of diabetic microangiopathy independently of age and sex. The CIMT, CAI x and PAI x were associated with the presence of diabetic microangiopathy only in the univariate model. Conclusions: In type 1 diabetic patients with microangiopathic complications, increased carotid IMT and arterial stiffness were observed. The study confirms the role of traditional risk factors for late diabetic complications, such as the duration of the disease and metabolic control in the development of microangiopathy.
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Rogowicz‐Frontczak et al. (2012) conducted a case-control in Type 1 diabetes (n=87). Diabetic microangiopathy vs. Type 1 diabetes without microangiopathy was evaluated on Carotid intima-media thickness (CIMT) (p=0.002). Type 1 diabetic patients with microangiopathy had significantly higher carotid intima-media thickness (median 0.53 mm vs 0.47 mm, p=0.002) and arterial stiffness compared to those without complications.
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