Coronary artery calcification, serum lipids, lipoproteins, and peripheral inflammatory markers in adolescents and young adults with type 1 diabetes.
OBJECTIVE
To determine whether coronary artery calcification (CAC), elevated fasting lipids, and lipoproteins and peripheral inflammatory markers are present in insulin-dependent diabetic adolescents and young adults several years after diagnosis.


METHODS
Hispanic insulin-dependent diabetics (n = 32) diagnosed a mean of 7.8 +/- 4.5 years ago (range, 3 to 16 years), with a mean glycosylated hemoglobin concentration at the time of the study of 8.8% +/- 2.3% and a mean chronological age of 16.1 +/- 4.4 years, were evaluated. Healthy patients (n = 15) with a chronological age (CA) of 15.2 +/- 2.2 years served as control subjects. CAC was assessed by multiple slice computed tomography, and total CAC score in Agatston units was calculated. Fasting lipids, C-reactive protein, apolipoprotein (Apo) A, Apo B, and metalloproteinase-9 (MMP-9) concentrations were measured in all subjects.


RESULTS
Neither adolescents with type 1 diabetes nor healthy control subjects presented with evidence of CAC. Fasting lipids, Apo A, Apo B, CRP, and MMP-9 concentrations were similar between diabetic subjects and control subjects. However, 34.4% and 25.0% of our type 1 diabetic subjects had elevated total and LDL cholesterol levels (>200 and >130 mg/dL, respectively), whereas 15.6% and 28.1% had elevated triglyceride and Apo B concentrations (>150 mg/dL and >100 mg/dL, respectively). In addition, 28.1% and 34.4% presented with elevated CRP and MMP-9 levels (>2 mg/L and >80 ng/mL, respectively). Total, LDL and HDL cholesterol, triglycerides, Apo B, CRP, and MMP-9 concentrations correlated positively with duration of the disease and with glycosylated hemoglobin levels.


CONCLUSIONS
Although the study adolescents with type 1 diabetes did not present any radiologic evidence of CAC at this stage of the disease, they remain a high-risk group for the development of microvascular and macrovascular artery disease, as risk factors such as elevated lipoproteins and proinflammatory markers are already present in a significant percentage of patients studied.
Gunczler
Peter
P
Pediatric Endocrine Unit, Hospital de Clínicas Caracas and Fundación Cardiovascular, Caracas, Venezuela. peterguncsler@hotmail.com
Lanes
Roberto
R
Soros
Arlette
A
Verdu
Livia
L
Ramon
Yolanda
Y
Guevara
Beatriz
B
Beer
Nusen
N
D000293:Adolescent; D000328:Adult; D001055:Apolipoproteins B / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D011859:Radiography
D001055:Apolipoproteins B; D008055:Lipids; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9