Family histories of Type II diabetes and hypertension predict intima-media thickness in patients with Type I diabetes.
OBJECTIVE
Hyperglycaemia predicts microvascular complications but data on macrovascular disease are limited. We searched for predictors of carotid artery intima-media thickness in young adults with Type I (insulin-dependent) diabetes mellitus.


METHODS
A total of 71 children (F/M = 34/37) were followed after their diagnosis until they reached 32 +/- 1 years of age, when duration of diabetes averaged 22 +/- 1 years. Cardiovascular risk markers [lipids, blood pressure, smoking, urinary albumin excretion rate, lifetime glycaemic exposure (A(1c) months), exercise habits, alcohol consumption, family history] were evaluated at age 21 +/- 1 for the baseline examination and at age 32 +/- 1 years for the follow-up examination years. During follow-up, intima-media thickness of common and internal carotid arteries and the carotid bulb were quantitated using a high-resolution B-mode ultrasound.


RESULTS
In univariate analysis, age, BMI, blood pressure, lifetime glycaemic exposure, a positive family history of Type II (non-insulin-dependent) diabetes mellitus, hypertension and cardiovascular disease were predictors of carotid intima-media thickness. In multivariate analysis, a positive family history of Type II diabetes predicted maximal ( p< 0.05) and common ( p< 0.005) carotid artery intima-media thickness, family history of hypertension predicted increases in maximal ( p< 0.04), and far wall ( p< 0.006) carotid artery intima-media thickness, and lifetime glycaemic exposure was an independent predictor of increased carotid bulb thickness ( p< 0.03).


CONCLUSIONS
Positive family histories of Type II diabetes and hypertension are independent predictors of carotid intima-media thickness in patients with Type I diabetes, and could therefore predispose these patients to atherosclerosis
Mäkimattila
S
S
Department of Medicine, Division of Diabetes, Helsinki University Central Hospital, Finland.
Ylitalo
K
K
Schlenzka
A
A
Taskinen
M-R
MR
Summanen
P
P
Syvänne
M
M
Yki-Järvinen
H
H
D000328:Adult; D000419:Albuminuria; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000235:genetics* / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics*; D003925:Diabetic Angiopathies / Q000235:genetics*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000235:genetics*; D008055:Lipids / Q000097:blood; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D014463:Ultrasonography
D001786:Blood Glucose; D008055:Lipids