Increased carotid intima-media thickness in Brazilian adolescents with type 1 diabetes mellitus

Fusaro, Maria Fernanda Gontijo Sepulveda; Zanini, Jovita Lane Soares Santos; Silva, Ivani Novato

doi:10.1186/s13098-016-0190-0

Cited by 13 publications

(10 citation statements)

References 37 publications

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“…The mean CIMT was also found to increase with age. (8), (9) In the diabetic group, male patients had higher mean CIMT (0.84±0.26 mm) as compared to the female patients (0.72±0.26 mm), (10) and similar result was found in control group as well. But, in case of metabolic syndrome, (11) the female patients had higher mean CIMT (0.74±0.19 mm) as compared to male patients (0.72± 0.22 mm).…”

Section: Discussionsupporting

confidence: 73%

Measurement of Mean Carotid Artery Intima Media Thickness in Patients of Diabetes Mellitus and Metabolic Syndrome

Agarwal¹,

Jain²,

Agarwal³

et al. 2019

jemds

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BACKGROUND Diabetes mellitus is associated with various microvascular and macrovascular complications. It has been suggested that the atherosclerotic process occurs at the same time in carotid, cerebral and coronary arteries. (1) In our study, we measured the carotid artery intima media thickness in patients of diabetes mellitus and metabolic syndrome. We also tried to determine the effect of duration of diabetes on carotid artery intima media thickness. METHODS Our study was cross sectional study conducted on 200 patients of diabetes mellitus and metabolic syndrome who presented to the outpatient and in-patient departments at the Department of Medicine, MLB Medical College, Jhansi (UP) over a period of 17 months, from June 2017 to October 2018. 100 non-diabetic and nonmetabolic syndrome patients were taken as controls. Ultrasonography was performed with B-mode images of a high-resolution ultrasound scanner equipped with 7 MHz linear array transducer. The mean CIMT was compared with various variables like diabetes and its types and duration, hypertension, age, sex, body mass index, glycosylated haemoglobin (HbA1c), dyslipidaemia, microvascular complications (like nephropathy and neuropathy) and other risk factors. RESULTS Out of the 300 subjects of our study, 179 were males (93 diabetic, 26 metabolic syndrome and 60 controls) and 121 females (65 diabetic, 16 metabolic syndrome and 40 controls). So, the male: female ratio in our study was 1.48:1, with maximum number (41.77%) of patients falling in 46-60 years age. The mean CIMT was found in general to increase with age, and significantly more in diabetic patients (0.791±0.261 mm) and metabolic syndrome patients (0.726±0.218 mm) than the controls (0.645±0.135 mm). While in diabetic patients it was observed that males had higher mean CIMT (0.84±0.26 mm), in the metabolic syndrome group of patients, females had a greater value of mean CIMT (0.74±0.19 mm). It was observed that the mean CIMT values increased proportionately with the duration of diabetes. CONCLUSIONS Carotid artery intima media thickness correlates positively and strongly with age, sex, body mass index, duration of diabetes. Therefore, mean CIMT appears to us as a surrogate marker of coronary atherosclerosis. Thus, we propose that mean CIMT should be measured in all diabetic and metabolic syndrome patients to screen them for possible complications of atherosclerosis, so that timely measures can be taken.

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Section: Discussionsupporting

confidence: 73%

Measurement of Mean Carotid Artery Intima Media Thickness in Patients of Diabetes Mellitus and Metabolic Syndrome

Agarwal¹,

Jain²,

Agarwal³

et al. 2019

jemds

View full text Add to dashboard Cite

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“…Few studies have utilized carotid artery intima-media thickness (CA-IMT) to assess vascular structural changes in children with CAH (4,5,7). A hindrance to the wider use of CA-IMT measurements in the pediatric population is the lack of standardization of CA-IMT values in this age group (8). Epicardial fat thickness (EFT) is a layer of adipose tissue surrounding the heart and coronary vessels which can be measured by ultrasound, a simple, noninvasive procedure (9).…”

Section: Introductionmentioning

confidence: 99%

Epicardial Fat Thickness in Children with Classic Congenital Adrenal Hyperplasia

Metwalley

Farghaly

Abdelhamid

2019

Jcrpe

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Objective: Epicardial fat thickness (EFT) is an emerging cardio-metabolic risk factor and has been shown to be related to atherosclerosis. EFT has not been studied in the context of CAH. This study aimed to evaluate EFT in children with CAH and its relation to carotid artery intima-media thickness (CA-IMT) and left ventricular (LV) functions. Methods: Thirty-six children with classical CAH were compared with 36 healthy controls. All patients had confirmed CAH and were receiving steroid substitution therapy. Patients and controls underwent anthropometric evaluation, measurement of fasting lipids, glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR). LV functions and EFT were assessed using conventional echocardiography. Duplex ultrasonography was used to measure CA-IMT. Results: Compared to controls, patients had greater EFT (p=0.001), CA-IMT (p=0.01), LV mass index (LVMI) (p=0.001) and prolonged mitral deceleration time (DcT) (p=0.01). CAH patients also had significantly worse HOMA-IR (p=0.001) than controls. Abnormalities were worse in uncontrolled CAH on treatment. Multivariate analysis in CAH subjects showed EFT correlated positively with waist circumference odds ratio (OR) [OR=1.9; 95% confidence interval (CI): 1.07-1.14; p=0.01], 17-hydroxyprogesterone [OR=1.6; 95% CI: 1.33-2.89; p=0.05], testosterone concentration (OR=1.7; 95% CI: 1.55-2.13; p=0.01), LVMI (OR=1.14; 95% Cl: 1.08-1.13; p=0.01), mitral DcT (OR=2.25; 95% CI: 1.15-2.05; p=0.01) and CA-IMT (OR=1.6; 95% CI: 1.15-2.05; p=0.01). Conclusion: EFT is elevated in children with classical CAH, particularly in those with poor control, and is correlated with CA-IMT, LV mass and mitral DcT. Measurement of EFT in CAH children may help to identify those at high risk of developing LV dysfunction and subclinical atherosclerosis.

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“…, 2 In pediatric cohorts, it has been also associated with cardiovascular risk factors, such as a family history of hypercholesterolemia, obesity, hypertension, and diabetes 3 4 , 5 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Intima-Media Thickness of the Carotid Arteries Is Affected by Pubertal Maturation in Healthy Adolescents

Zanini

Rodrigues

Barra

et al. 2019

Rev. paul. pediatr.

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Objective: To contribute to the assessment of normal parameters of carotid intima-media thickness (CIMT) in healthy adolescents.Methods: A cross-sectional study was conducted through clinical, laboratory and ultrasound evaluation in 61 healthy adolescents. The inclusion criteria consisted of being in good health. The exclusion criteria were: presence or history of any chronic disease; being obese or overweight according to the World Health Organization (WHO) established criterion; continuous use of medication; or presenting a febrile condition or requiring medication within 48-hours prior to assessment. The pubertal stages were evaluated using the Tanner criteria. The high-resolution B-mode ultrasound examinations were performed according to the recommendations of the Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force.Results: Adolescents were 14±2.6 years old, 62.3% female, 19 (31%) at early puberty (Tanner II and III), and 38 (62%) at late puberty (Tanner IV and V). They presented normal clinical and laboratorial parameters. CIMT values were 0.46±0.04 to 0.55±0.04 mm on the right and 0.48±0.02 to 0.53±0.04 mm on the left, according to pubertal maturation. CIMT values increased significantly on the right and left sides, according to pubertal stage (p<0.001 and p=0.016), and maximum internal diameters of the common carotid artery (p<0.025 and p<0.003). It was higher in males compared to females.Conclusions: An increase in CIMT in the healthy adolescents group, according to both age, and the degree of pubertal maturation should be considered when evaluating adolescents in diagnostic procedures.

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Increased carotid intima-media thickness in Brazilian adolescents with type 1 diabetes mellitus

Cited by 13 publications

References 37 publications

Measurement of Mean Carotid Artery Intima Media Thickness in Patients of Diabetes Mellitus and Metabolic Syndrome

Measurement of Mean Carotid Artery Intima Media Thickness in Patients of Diabetes Mellitus and Metabolic Syndrome

Epicardial Fat Thickness in Children with Classic Congenital Adrenal Hyperplasia

Intima-Media Thickness of the Carotid Arteries Is Affected by Pubertal Maturation in Healthy Adolescents

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