Cardiovascular Disease and Its Risk Factors in IDDM in Europe

Koivisto, V A; Stevens, L. K.; Mattock, M. B.; Ebeling, Pertti; Muggeo, Michele; Stephenson, Judith; Idzior−Waluś, Barbara

doi:10.2337/diacare.19.7.689

Cited by 181 publications

(136 citation statements)

References 32 publications

(45 reference statements)

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“…Macrovascular disease CVD was defined as a positive medical history of a cardiovascular event, including myocardial infarction, angina, coronary artery bypass graft and/or stroke, and/or ischaemic changes on a centrally Minnesota-coded ECG [34].…”

Section: Main Outcomesmentioning

confidence: 99%

Levels of soluble receptor for AGE are cross-sectionally associated with cardiovascular disease in type 1 diabetes, and this association is partially mediated by endothelial and renal dysfunction and by low-grade inflammation: the EURODIAB Prospective Complications Study

et al. 2009

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Aims/hypothesis Plasma soluble receptor for AGE (sRAGE) may reflect the activity of the AGE-RAGE axis, which has been proposed as a potential mechanism linking hyperglycaemia to vascular complications in diabetes. We have therefore investigated: (1) whether sRAGE is associated with greater prevalence of cardiovascular disease (CVD) and microvascular complications in type 1 diabetic individuals; and (2) the extent to which any such associations are explained by markers of endothelial and renal dysfunction and inflammation.Methods The study included 477 individuals (234 women; mean age 42± 10 [SD] years) from the EURODIAB Prospective Complications Study. We used linear regression analyses to investigate the differences in sRAGE levels between individuals with and without vascular complications. All analyses were adjusted for age, sex, HbA 1c , duration of diabetes and other risk factors. Results Individuals with CVD (n=116) had higher levels of sRAGE than those without CVD or any microvascular complications (n =178): β =0.15 (95% CI 0.04-0.27).Diabetologia (2009) inflammation (β=0.12 [0.01-0.23]) attenuated these differences; altogether these variables explained about 50% of the association between sRAGE and prevalent CVD. sRAGE levels tended to be higher in the presence and across the levels of severity of albuminuria (p for trend= 0.087) and retinopathy (p for trend=0.057); adjustments for endothelial and renal dysfunction and inflammation also attenuated these differences. Conclusions/interpretation sRAGE is associated with greater prevalence of CVD in type 1 diabetic individuals, and these associations may be partly explained by endothelial and renal dysfunction and low-grade inflammation.

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Section: Main Outcomesmentioning

confidence: 99%

Levels of soluble receptor for AGE are cross-sectionally associated with cardiovascular disease in type 1 diabetes, and this association is partially mediated by endothelial and renal dysfunction and by low-grade inflammation: the EURODIAB Prospective Complications Study

et al. 2009

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“…1,2 In particular, patients with clinical diabetic nephropathy and a long duration of diabetes have an extremely high morbidity from macrovascular disease. [2][3][4][5] Proteinuria and microalbuminuria in patients with type 1 diabetes are known to be associated with several adverse cardiovascular risk factors, including hypertension and lipoprotein abnormalities, characterized mainly by elevated serum total and LDL cholesterol and high total and VLDL triglyceride levels, low HDL cholesterol, and low ApoA1 levels. 6 -8 Chronic hyperglycemia 9 -12 and poor glycemic control [13][14][15][16] have been implicated in the pathogenesis of microvascular complications in patients with type 1 diabetes, but little data are available on the role of these factors for the development of macrovascular complications.…”

mentioning

confidence: 99%

Poor Glycemic Control Predicts Coronary Heart Disease Events in Patients With Type 1 Diabetes Without Nephropathy

Lehto

Rönnemaa

Pyörälà

et al. 1999

ATVB

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Abstract-Patients with type 1 diabetes mellitus, especially those with nephropathy, are at increased risk for coronary heart disease (CHD). However, information on the predictive value of cardiovascular risk factors and the degree of hyperglycemia with respect to CHD events in patients with type 1 diabetes without nephropathy is still incomplete. Therefore, we performed a prospective study on risk factors for CHD in patients with type 1 diabetes free of clinical nephropathy. At baseline examination, cardiovascular risk factor levels of CHD were determined in 177 patients with type 1 diabetes (87 men and 90 women), age 45 to 64 years at baseline and Ն30 years at the time of diagnosis of diabetes. These patients were followed up to 7 years with respect to CHD events.

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“…Entretanto, este comportamento não foi observado no grupo de púberes, que apresentou menor tempo de duração do DM do que o grupo de adultos. Possivelmente este achado se deve ao fato de que a maior duração da doença está relacionada à maior ocorrência de complicações crônicas, que freqüentemente são associadas com aumento da pressão arterial (2). Não observamos correlação entre PAS e PAD com IMC, o que pode decorrer da nossa população ter incluído predominantemente pacientes com IMC normal.…”

Section: Discussionunclassified

“…Dois estudos, baseados em aferição auscultatória da PAS e PAD, demonstraram que a hipertensão pode ser em alguns pacientes fator de risco para doença coronariana, independente da presença de nefropatia diabética incipiente e/ou clínica (2,18). Entretanto, no paciente que apresentou alterações tensionais apenas no primeiro dia de aferição da pressão arterial, não podemos excluir o fenômeno do "white coat hypertension", descrito em pacientes não diabéti-cos, especialmente se a aferição é realizada por médico (19).…”

Section: Discussionunclassified

“…A doença e/ou suas complicações crônicas são hoje uma das principais causas de mortalidade e morbidade em diferentes grupos populacionais com elevados custos diretos e indiretos. Das complicações crônicas destacamos a nefropatia diabética e a macroangiopatia, que pode se manifestar como doença coronariana, vascular cerebral e vascular de membros inferiores, como as mais devastantes para o paciente diabético (2).…”

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Variabilidade da pressão arterial de consultório em pacientes com diabetes mellitus do tipo 1

Gomes

Júnior

Clemente

1999

Arq Bras Endocrinol Metab

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Recebido em 13/05/98Revisado em 11/01/99 e 31/03/99 Aceito em 02/04/99 RESUMO Objetivo: Analisar a associação da variabilidade da pressão arterial auscultatória sistólica (PAS) e diastólica (PAD) com variáveis clínicas do diabetes tipo 1 (DM1). Métodos: Foram estudados 58 pacientes com DM1 (33 mulheres) com 24,6±8,5 (9-43) anos e duração do diabetes de 8, 4±6,6 (0,4-36) anos, sendo 46 adultos e 12 púberes. A PAS e a PAD foram aferidas em três diferentes dias na posição supina, antes e após 5 e 10 min de repouso, calculando-se o coeficiente de variação médio (CVM) e intraindividual (CVI). Resultados; O CVM da PAS entre os diferentes tempos de aferição variou de 3,0 a 3,6% (adultos) e 3,3 a 4,6% (púberes) e o da PAD de 5,5 a 6,6% (adultos) e 6,3 a 7,4% (púberes).O CVM da PAS entre os diferentes dias de aferição variou de 6,4 a 6,8% (adultos) e 8,7 a 9,2% (púberes), sendo o CVI da PAS sem e após 5 min de repouso maior em púberes do que adultos, respectivamente (8,1 ±3,1 vs 5,3±4,1%; p=0,004) e (7,9±4,7 vs 5,2±3,7%; p=0,02) e apresentando uma maior correlação com a idade (PAS antes e após 5 min de repouso, respectivamente r= -0,34; r2= 0,12; p=0,007 e r= -0,31; r2= 0,09; p=0,01. O CVM da PAD entre os diferentes dias de aferição variou de 9,7 a 10,1% para os adultos e de 13 a 14,2% para os púberes. Nos adultos observamos diminuição da PAS e PAD entre os diferentes tempos de aferição e uma maior correlação entre duração do diabetes e PAS final após 5 min (r = 0,39; r2 = 0,15; p=0,007) e PAD após 10 min de repouso (r= 0,36; r2 = 0,13; p= 0,01). Conclusão: A variabilidade da PAS e PAD entre os diferentes dias e tempos de aferição observados neste estudo justificam a necessidade da realização de várias aferições após repouso de até 10 min em ambiente apropriado para o acompanhamento ambulatorial de rotina do paciente com DM1. (Arq Bras Endocrinol Metab 1999;43/2: 96-103). Unitermos: Diabetes mellitus tipo 1; Pressão arterial; Variabilidade ABSTRACTObjective: To determine the relationship between the variability of office systolic (SBP) and diastolic (DBP) blood pressure with clinical variables of DM1. Methods: SBP and DBP were measured before and after 5 and 10 min of supine rest on three different days. The mean (CVM) and intraindividual (CVI) coefficients of variation for SBP and DBP were determined for the three different days and times of measurement. Results: The CVM of SBP for the three periods of measurement varied from 3.0 to 3.6% in adults and 3.3 to 4.6% in adolescents and for DBP from 5.5 to 6.6% in adults and 6.3 to 7.4% in adolescents. The CVM of SBP for the three days ranged from 6.4 to 6.8% in adults and 8.7 to 9.2% in adolescents with a higher CVI of SBP before and after 5 min of rest in adolescent than adult patients, respectively (8.1 ±3.1% vs 5.3±4.1%; p=0.004) and (7.9±4.7% vs 5.2±3.7%; p=0.02), which correlated with age: SBP before and after 5 min of rest (r= -0.34; r2= 0.12; p=0.007) and r= -0.31; r2=0.09; p=0.01), respectively. CVM for DBP varied from 9.7 to 10.1% in adults and 13 to 14.2% in ado...

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Cardiovascular Disease and Its Risk Factors in IDDM in Europe

Cited by 181 publications

References 32 publications

Levels of soluble receptor for AGE are cross-sectionally associated with cardiovascular disease in type 1 diabetes, and this association is partially mediated by endothelial and renal dysfunction and by low-grade inflammation: the EURODIAB Prospective Complications Study

Levels of soluble receptor for AGE are cross-sectionally associated with cardiovascular disease in type 1 diabetes, and this association is partially mediated by endothelial and renal dysfunction and by low-grade inflammation: the EURODIAB Prospective Complications Study

Poor Glycemic Control Predicts Coronary Heart Disease Events in Patients With Type 1 Diabetes Without Nephropathy

Variabilidade da pressão arterial de consultório em pacientes com diabetes mellitus do tipo 1

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