Genetic Risk Factors for CVD in Type 1 Diabetes: The DCCT/EDIC Study

Bebu, Ionut; Keshavarzi, Sareh; Gao, Xiaoyu; Braffett, Barbara H.; Canty, Angelo J.; Herman, William H.; Orchard, Trevor J.; Dagogo‐Jack, Samuel; Nathan, David M.; Lachin, John M.; Paterson, Andrew D.; Dcct,

doi:10.2337/dc20-2388

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Likewise, allowing for differences in diagnostic criteria, the prevalence of peripheral neuropathy (67%) in this study was greater than in community T1DCC patients (50%), 1 and in patients with T1D in the Epidemiology of Diabetes Interventions and Complications cohort (29%) 33 . Similar to cardiovascular disease 34 and retinopathy 35 in patients with diabetes, it is conceivable that other unknown, potentially genetic risk factors influence the likelihood of anorectal sensorimotor dysfunction.…”

Section: Discussionmentioning

confidence: 60%

Defecatory disorders in patients with type 1 diabetes and chronic constipation

Xiao

Ramu

Gautam

et al. 2023

Neurogastroenterology Motil

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Background and objectives: Chronic constipation (CC) may be caused by defecatory disorders (DDs) and associated with reduced rectal sensation. Among patients with type 1 diabetes (T1D) and CC (T1DCC patients), the prevalence of DDs and reduced rectal sensation is unknown. We sought to compare complications of T1D, anorectal dysfunction, and CC symptoms, among T1DCC patients with versus without a DD.Methods: Anorectal pressures at rest and during squeeze and evacuation, as well as rectal sensation and rectal balloon expulsion time (BET) were measured with highresolution anorectal manometry in 114 consecutive T1DCC patients.Results: Thirty-seven patients (32%) had prolonged BET, suggestive of a DD.Complications of T1D included peripheral neuropathy (n = 67, 59%), retinopathy (n = 42, 37%), and nephropathy (n = 26, 23%). Among these complications, only retinopathy was associated with, that is, more prevalent in patients with normal (45%) than prolonged BET (19%). Compared with patients with normal BET, patients with prolonged BET had a lower rectal pressure (mean [SD], 32 [23] mm Hg vs. 23 [19] mmHg, p = 0.03), greater anal pressure (91 [23] mm Hg vs. 68 [36] mm Hg, p < 0.001), and lower rectoanal gradient (−67 [30] mm Hg vs. −36 [32] mm Hg, p < 0.0001) during evacuation. Anal resting pressure and anal squeeze increment were below normal in 14 (13%) and 32 (29%) of patients and one or more rectal sensory thresholds were above normal in 34 (30%) patients; these abnormalities affected similar proportions in the normal and prolonged BET cohorts.Conclusions: Among T1DCC patients, 37 (32%) had prolonged BET, which was associated with anorectal pressures indicative of a DD but was not associated with reduced rectal sensation, suggesting that DDs are more likely explained by abdomino-anal dyscoordination than visceral disturbance.

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Section: Discussionmentioning

confidence: 60%

Defecatory disorders in patients with type 1 diabetes and chronic constipation

Xiao

Ramu

Gautam

et al. 2023

Neurogastroenterology Motil

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“…4 Department of Medicine, University of Turku, Turku, Finland. 5 Centre for Rheumatology and Clinical Immunology, Division of Medicine, Turku University Hospital, Turku, Finland. 6 Department of Public Health, University of Turku, Turku, Finland.…”

Section: Abbreviationsmentioning

confidence: 99%

“…CVD is the leading cause of death in patients with type 1 diabetes and results in premature mortality in this high-risk population [2]. The substantially elevated risk for myocardial infarction (MI) in patients with type 1 diabetes has been acknowledged for decades and is steeply associated with levels of traditional CVD risk factors and genetic factors [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Long-term cardiovascular prognosis of patients with type 1 diabetes after myocardial infarction

Kerola

Semb

Juonala

et al. 2022

Cardiovasc Diabetol

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Background To explore long-term cardiovascular prognosis after myocardial infarction (MI) among patients with type 1 diabetes. Methods Patients with type 1 diabetes surviving 90 days after MI (n = 1508; 60% male, mean age = 62.1 years) or without any type of diabetes (n = 62,785) in Finland during 2005–2018 were retrospectively studied using multiple national registries. The primary outcome of interest was a combined major adverse cardiovascular event (MACE; cardiovascular death, recurrent MI, ischemic stroke, or heart failure hospitalization) studied with a competing risk Fine-Gray analyses. Median follow-up was 3.9 years (maximum 12 years). Differences between groups were balanced by multivariable adjustments and propensity score matching (n = 1401 patient pairs). Results Cumulative incidence of MACE after MI was higher in patients with type 1 diabetes (67.6%) compared to propensity score-matched patients without diabetes (46.0%) (sub-distribution hazard ratio [sHR]: 1.94; 95% confidence interval [CI]: 1.74–2.17; p < 0.0001). Probabilities of cardiovascular death (sHR 1.81; p < 0.0001), recurrent MI (sHR 1.91; p < 0.0001), ischemic stroke (sHR 1.50; p = 0.0003), and heart failure hospitalization (sHR 1.98; p < 0.0001) were higher in patients with type 1 diabetes. Incidence of MACE was higher in diabetes patients than in controls in subgroups of men and women, patients aged < 60 and ≥ 60 years, revascularized and non-revascularized patients, and patients with and without atrial fibrillation, heart failure, or malignancy. Conclusions Patients with type 1 diabetes have notably poorer long-term cardiovascular prognosis after an MI compared to patients without diabetes. These results underline the importance of effective secondary prevention after MI in patients with type 1 diabetes.

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“…To improve the efficiency of prevention, determining the risk factors of hypertension and diabetes over a geographic area are crucial. It is worth noting that hypertension and diabetes share common risk factors, such as individual behavior, family history, genetic factors, and lifestyle [ 6 – 8 ]. Due to some shared pathogenic mechanisms, these two diseases coexist frequently and have similar spatial distribution patterns.…”

Section: Introductionmentioning

confidence: 99%

Association of long-term exposure to PM2.5 with hypertension and diabetes among the middle-aged and elderly people in Chinese mainland: a spatial study

et al. 2022

BMC Public Health

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Background Epidemiological evidence has shown an association between long-term exposure to fine particulate matter (PM2.5) and hypertension and diabetes, but few studies have considered the spatial properties of the samples. This study aimed to investigate the long-term effect of PM2.5 exposure on hypertension and diabetes among middle-aged and elderly people in China based on a spatial study. Methods We conducted a national cross-sectional study of the most recently launched wave 4 2018 data of the China Health and Retirement Longitudinal Study (CHARLS) to calculate the prevalence of hypertension and diabetes. The exposure data of annual average PM2.5 concentrations were estimated combined with satellite observations, chemical transport modeling, and ground-based monitoring. A shared component model (SCM) was used to explore the association of PM2.5 with hypertension and diabetes, in which these two diseases borrowed information on spatial variations from each other. Then, we evaluated the effect variations in PM2.5 in different periods and smoking status on changes in outcomes. Results The prevalence of hypertension and diabetes was 44.27% and 18.44%, respectively, among 19,529 participants. The annual average PM2.5 concentration in 31 provinces ranged from 4.4 μg/m3 to 51.3 μg/m3 with an average of 27.86 μg/m3 in 2018. Spatial auto-correlations of the prevalence of hypertension and diabetes and PM2.5 concentrations were seen (Moran’s I = 0.336, p = 0.01; Moran’s I = 0.288, p = 0.03; Moran’s I = 0.490, p = 0.01). An interquartile range (IQR: 16.2 μg/m3) increase in PM2.5 concentrations was significantly associated with a higher prevalence of hypertension and diabetes with odds ratios (ORs) of 1.070 [95% credible interval (95% CrI): 1.034, 1.108] and 1.149 (95% CrI: 1.100, 1.200), respectively. Notably, the effect of PM2.5 on both hypertension and diabetes was relatively stronger among non-smokers than smokers. Conclusion Our nationwide study demonstrated that long-term exposure to PM2.5 might increase the risk of hypertension and diabetes, and could provide guidance to public policymakers to prevent and control hypertension and diabetes according to the spatial distribution patterns of the above effects in China.

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Genetic Risk Factors for CVD in Type 1 Diabetes: The DCCT/EDIC Study

Cited by 4 publications

References 25 publications

Defecatory disorders in patients with type 1 diabetes and chronic constipation

Defecatory disorders in patients with type 1 diabetes and chronic constipation

Long-term cardiovascular prognosis of patients with type 1 diabetes after myocardial infarction

Association of long-term exposure to PM2.5 with hypertension and diabetes among the middle-aged and elderly people in Chinese mainland: a spatial study

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