Is subclinical atherosclerosis associated with visceral fat and fatty liver in adolescents with type 1 diabetes?

Abstract

IntroductionThere is a 3-fold higher prevalence of cardiovascular complications in patients with type 1 diabetes. The aim was to assess the relationship between subclinical atherosclerosis and visceral fat and fatty liver in diabetic adolescents.Material and methodsThe study was performed on 110 adolescents with type 1 diabetes (T1D) attending the Pediatric Diabetes Clinic of the University Hospital, Ismailia, Egypt. Their mean age was 14.2 ±0.7 years with a mean duration of diabetes 6 ±0.3 years. They were divided into group 1 which consisted of 55 adolescents with T1D and normal carotid intima media thickness (cIMT) and the second group which included 55 adolescents with T1D and subclinical atherosclerosis. All adolescents were normotensive, normo-albuminuric and had no retinopathy. Visceral fat thickness was measured as the distance between the anterior wall of the aorta and the posterior surface of the rectus abdominis muscle. Hepatic steatosis was diagnosed based on enlarged liver size and evidence of diffuse hyper-echogenicity of liver relative to kidneys.ResultsThe mean visceral fat was significantly higher in adolescents with increased cIMT (4.8 ±1.6) than in the normal thickness group (3.9 ±1.4). Liver size was also significantly larger in the former group (13.73 ±2.26 versus 12.63 ±2.20) (p = 0.022). After adjusting for other variables, logistic regression demonstrated that glycated hemoglobin (HbA1c) and fatty liver are independent factors affecting cIMT, OR = 1.426 (p < 0.05) and OR = 4.71 (p < 0.05).ConclusionsIn the present study, fatty liver and HbA1c were associated with subclinical atherosclerosis in lean adolescents with T1D.

Endocan and a novel score for dyslipidemia, oxidative stress and inflammation (DOI score) are independently correlated with glycated hemoglobin (HbA1c) in patients with prediabetes and type 2 diabetes

“…Inflammation is one of the underlying risks of β cell damage and IR in patients with T2D [2]. Furthermore, the vicious circle of hyperinsulinemia and hyperglycemia and the prolonged burden of pro-inflammatory cytokines lead to deeper imbalance in the lipoprotein levels, promote lipid peroxidation, as well as oxidative modification of protein structures, and aggravate endothelial dysfunction and atherosclerosis [6,24]. Having these facts in mind, a novel inflammation biomarker of endothelial dysfunction, such as endocan [3], and a comprehensive DOI score which includes all these key features of T2D may be important determinants of the progression of this metabolic disorder.…”

“…The potential of endocan to stimulate secretion of proinflammatory cytokines by endothelial cells, as well as its ability to enhance the permeability of blood vessels may increase atherosclerotic disease risk burden [9], especially in subjects with prediabetes and T2D. Since poor glucoregulation represents an important risk factor for CVD morbidity and mortality [15,24], further prospective studies are needed to elucidate whether determination of examined biomarkers (i.e. endocan and DOI scores) in a timely manner may be useful to detect increased atherosclerotic risk and also to elucidate whether the lowering of these biomarkers can enable prevention of T2D and/or its vascular complications.…”

Diabetes and carotid artery disease: a narrative review

“…Liver steatosis (as assessed by fatty liver index) was associated with carotid and coronary (but not femoral atherosclerosis) and with CV mortality risk (as assessed by the 10-year Framingham Risk Score) (50). In another study, after adjusting for several variables, logistic regression demonstrated that HbA 1c levels and fatty liver were independent predictors of cIMT (OR 1.426, 95% CI: 1.084-1.876, P=0.011 and 4.718, 95% CI: 1.083-20.542, P=0.039, respectively) (51). This study was conducted in lean (BMI 23.3±4.6 and 22.4±4.4 kg/m 2 ) adolescents with T1DM and with or without increased cIMT (n=110; mean age: 14.2±0.7 years; mean duration of T1DM: 6.0±0.3 years) (51).…”

Immunometabolism in type 2 diabetes mellitus: tissue-specific interactions

“…Increased serum free fatty acids (FFAs) levels have been associated with insulin resistance in obese individuals [20][21][22][23]. Especially saturated FFAs have been correlated with induction of the inflammatory response and insulin resistance in insulin target tissues, while polyunsaturated FFAs have been described as generally anti-inflammatory [24].…”