Magnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus

Królewski, A. S.; Kosinski, Edward J.; Warram, James H.; Leland, O. Stevens; Busick, E J; Asmal, A. C.; Rand, Lawrence I.; Christlieb, A. R.; Bradley, Robert F.; Kahn, C. Ronald

doi:10.1016/0002-9149(87)91086-1

Cited by 599 publications

(332 citation statements)

References 31 publications

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“…It is well established that patients with diabetes mellitus are at a two to four fold greater risk of cardiovascular disease (CVD) [1,2]. The increased risk has been attributed in part to hyperglycaemia.…”

Section: Introductionmentioning

confidence: 99%

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

et al. 2005

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Background: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a potential confounder. Methods: An observational study was performed in 215 subjects with type 1 diabetes treated with multiple insulin injection therapy. Atherosclerosis was assessed by measurement of carotid intima-media thickness (CIMT). Results: The cumulative dose of regular insulin showed a positive and significant relation with CIMT: increase of 21 m in CIMT per S.D. of insulin use (95% CI: 8-35 adjusted for gender and age), which remained unchanged after adjustment for duration of diabetes, HbA1c, BMI, pulse pressure, physical activity and carotid lumen diameter. A similar relation was found for intermediate-acting insulin: 15.5 m per S.D. (2-29), which was no longer present after further adjustment. Conclusions: These findings provide evidence that a high cumulative dose of regular insulin is a risk factor for atherosclerosis.

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Section: Introductionmentioning

confidence: 99%

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

et al. 2005

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“…Diabetic nephropathy is a major determinant of the excess morbidity and premature death associated with type I diabetes mellitus (1,2). Although clinical studies have clearly demonstrated that prolonged hyperglycemia is an important risk factor for the development of this complication (3,4), epidemiologic and family studies suggest that genetic susceptibility also plays a critical role (5,6).…”

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confidence: 99%

Identification of a Common Risk Haplotype for Diabetic Nephropathy at the Protein Kinase C-β1 (PRKCB1) Gene Locus

Araki¹,

Ng²,

Krolewski³

et al. 2003

Journal of the American Society of Nephrology

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Abstract. Abnormal activation of protein kinase C-␤ isoforms in the diabetic state has been implicated in the development of diabetic nephropathy. It is thus plausible that DNA sequence differences in the protein kinase C-␤1 gene (PRKCB1), which encodes both ␤I and ␤II isoforms, may influence susceptibility to nephropathy. Nine single-nucleotide polymorphisms (SNP) in PRKCB1 were tested for association with diabetic nephropathy in type I diabetes mellitus, by using both case-control and family-study designs. Allele and genotype distributions of two SNP in the promoter (Ϫ1504C/T and Ϫ546C/G) differed significantly between case patients and control patients (P Ͻ 0.05). These associations were particularly strong with diabetes mellitus duration of Ͻ24 yr (P ϭ 0.002). The risk of diabetic nephropathy was higher among carriers of the T allele of the Ϫ1504C/T SNP, compared with noncarriers (odds ratio, 2.54; 95% confidence interval, 1.39 to 4.62), and among carriers of the G allele of the Ϫ546C/G SNP (odds ratio, 2.45; 95% confidence interval, 1.37 to 4.38). Among individuals with diabetes mellitus duration of Ն24 yr, these two SNP were not associated with diabetic nephropathy. These positive findings were confirmed by using the family-based transmission disequilibrium test. The T-G haplotype, with both risk alleles, was transmitted more frequently than expected from heterozygous parents to offspring who developed diabetic nephropathy during the first 24 yr of diabetes mellitus. It is concluded that DNA sequence differences in the promoter of PRKCB1 contribute to diabetic nephropathy susceptibility in type I diabetes mellitus.

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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.…”

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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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Magnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus

Cited by 599 publications

References 31 publications

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

Identification of a Common Risk Haplotype for Diabetic Nephropathy at the Protein Kinase C-β1 (PRKCB1) Gene Locus

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

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