Preclinical arterial disease in patients with type 1 diabetes without other major cardiovascular risk factors or micro-/ macrovascular disease

Abstract

We aimed to investigate preclinical atherosclerosis in T1D and its relationship with glucose profile and endothelial/ inflammatory markers. Thirty-eight T1D patients without additional cardiovascular risk factors or micro-/macrovascular complications and 22 healthy matched subjects were included. FMD and cIMT/fIMT were performed in addition to 72-h continuous glucose monitoring and the measurement of endothelial/inflammatory markers. Lower FMD percentages and greater cIMT/fIMT were observed in patients with T1D in comparison with controls (FMD 7.0±3.1% vs. 9.6±2.2%; p<0.005; cIMT 0.523±0.091 mm vs. 0.471±0.061 mm; p<0.05 and fIMT 0.512±0.172mm vs. 0.394±0.061mm; p<0.01, for patients and controls, respectively). T1D subjects in the highest tertile of cIMT were older than those in the lowest group (39.9±9.5 vs. 29.6±4.7 years; p<0.005) and had a longer duration of the disease (18.7±5.4 years vs. 11.8±6.4 years). The higher the cIMT tertile, the greater the fIMT (0.397±0.114 mm vs. 0.431±0.082 mm vs. 0.583±0.197 mm; p<0.05). MAGE was negatively correlated to FMD (r=-0.328; p<0.05) and positively to cIMT (r=0.322; p<0.05). There were no differences between cIMT tertiles in terms of metabolic parameters or endothelial and inflammatory markers. Signals of preclinical atherosclerosis in T1D even in the absence of cardiovascular risk factors and micro-/ macrovascular disease are reported. Our findings suggest that daily glucose instability could negatively impact vascular function and structure.

Endothelial dysfunction in children with type 1 diabetes mellitus

“…The arterial lumen diameter was defined as the distance between the intima of the far and near vessel walls. The dilatation was calculated by subtracting the lumen diameter at baseline from the maximal lumen diameter after ischemia and dividing the result by the lumen diameter at baseline (12). Results were expressed as a percentage FMD (%).…”

Enfermedad cardiovascular en pacientes con diabetes mellitus tipo 1 y tipo 2 en España

“…De la base de datos del estudio Di@bet.es se incluyeron 3.430 sujetos con metabolismo hidrocarbonado normal y 312 pacientes con diabetes conocida previamente y referida mediante el cuestionario administrado por la enfermera responsable (tabla 1). La duració n mediana de la diabetes fue superior en los pacientes con DM1 que en los DM2 (mediana [intervalo intercuartílico] de 16 [10-23] frente a 7 [3][4][5][6][7][8][9][10][11][12][13][14][15] añ os). La HbA 1c media (DE) de los pacientes con DM1 fue de 8,3 (1,2) %, y en un 33 y un 14% existía algú n grado de retinopatía o nefropatía diabé tica, respectivamente (tabla 1).…”

“…En este sentido, nuestro grupo ya había demostrado en una serie de pacientes jó venes con DM1 con una duració n significativa de la enfermedad, sin complicaciones microvasculares ni otros FRCV, un mayor valor medio del grosor de la íntima media (GIM) carotídeo (correspondiente en promedio al esperable en sujetos 10 añ os mayores) y de la presencia de placa carotídea (un 18% presentaron placa, hallazgo no esperable en su grupo etario) al observado en una població n control de similar edad y sexo 10 . Má s recientemente, un grupo de investigadores de nuestro entorno ha puesto de manifiesto un aumento de la rigidez arterial en pacientes con DM1 en comparació n con un grupo control de similar edad y sexo, y otros FRCV clá sicos 11 .…”

Impaired flow-mediated dilation response and carotid intima-media thickness in patients with type 1 diabetes mellitus with a mean disease duration of 4.1 years

“…Thus, good metabolic control, which is difficult to achieve, seems to be insufficient to prevent the development of micro-and macro-vascular complications (24).…”