Carotid intima media thickness decreases after pancreas transplantation.
BACKGROUND
Pancreas transplantation (PTX) improves diabetic microvascular complications, but it is unknown whether PTX alters macrovascular disease. Carotid intima media thickness (IMT) has been shown to correlate with cardiovascular events, so this study was designed to evaluate changes in carotid IMT after PTX.


METHODS
Four groups were studied: PTX candidates (n=60); successful PTX recipients (n=89; mean time since PTX=4.0+/-0.3 years); patients with type 1 diabetes but without nephropathy (n=20); and normal controls (n=32). Mean IMT and mean of maximum carotid IMT measurements (mean-max IMT), hemoglobin A1C, serum creatinine, body mass index (BMI), blood pressure, smoking status, use of hypolipidemic medications, and fasting lipids were determined in all groups.


RESULTS
Age, gender distribution, and BMI were not different among the groups. Duration of diabetes was also equal between pre- and post-PTX groups. Mean and mean-max IMT were greatest pre-PTX and decreased after PTX (P<0.05) to a value that was not different from controls. Hemoglobin A1C and creatinine decreased, and high density lipoprotein (HDL) increased after PTX (P<0.05), but there were no significant differences in other lipids, BMI, use of lipid lowering agents, blood pressure, or smoking status.


CONCLUSIONS
Carotid IMT is lower after PTX, suggesting a reduction in overall cardiovascular risk independent of changes in use of hypolipidemic agents, smoking, blood pressure, BMI, or lipids, except HDL. Improved carotid IMT after successful PTX predicts a reduction in future vascular disease events and suggests that the macrovascular disease of type 1 diabetes is at least partially reversible with improved glucose control.
Larsen
Jennifer L
JL
Department of Internal University of Nebraska Medical Center and Nebraska Health System, Omaha, Nebraska 68198-3020, USA. jlarsen@unmc.edu.
Ratanasuwan
Tanaporn
T
Burkman
Tab
T
Lynch
Thomas
T
Erickson
Judi
J
Colling
Christopher
C
Lane
James
J
Mack-Shipman
Lynn
L
Lyden
Elizabeth
E
Loseke
Melissa
M
Miller
Suzanne
S
Leone
John
J
D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002339:Carotid Arteries / Q000473:pathology*; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D016035:Pancreas Transplantation / Q000473:pathology*; D012016:Reference Values; D012907:Smoking; D013997:Time Factors; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*
D003404:Creatinine; D006442:Glycated Hemoglobin; D008055:Lipids