Age of onset of type 1 diabetes in children and carotid intima medial thickness.
BACKGROUND
Cardiovascular disease due to atherosclerosis is a major cause of morbidity and mortality in adult diabetic patients. In children, signs of subclinical atherosclerosis such as increased intima-media thickness (IMT) of the common carotid arteries have been detected in several studies. However, concerns may arise about the different analyzing methods used because measurements in patients and controls differ significantly.


METHODS
We studied 208 children [150 patients with diabetes mellitus type 1, mean age (+/-sd) 13.9 +/- 2.8 yr, 66 males, mean glycosylated hemoglobin (+/-sd) 7.8 +/- 1.4%, and 58 healthy controls, mean age (+/-sd) 14.1 +/- 3.1 yr, 32 males] and used normal IMT values published recently for comparison of the results.


RESULTS
Of 150 patients, 37 had an increased IMT [mean IMT (+/-sd) 1.6 +/- 0.6], whereas healthy controls had nearly normal IMT values [mean IMT (+/-sd) 0.3 +/- 0.1; P < 0.001]. Age at onset of diabetes, mean daily insulin dosage, systolic blood pressure, and total cholesterol level were significantly related to IMT in a multilinear regression model. A total of 25 diabetic patients were hypertensive and had a significantly increased IMT (mean IMT 0.475 +/- 0.03 mm) compared to the remaining patients (mean IMT 0.459 +/- 0.02 mm; P < 0.05).


CONCLUSIONS
The IMT measurement detected subclinical atherosclerosis in a large cohort of diabetic children. Systolic blood pressure, total cholesterol level, insulin dosage, and age at onset of the disease were significantly related to the IMT. Longitudinal measurements may help to identify patients at special risk for atherosclerotic changes and cardiovascular disease.
Dalla Pozza
Robert
R
Department of Pediatric Cardiology, University Children's Hospital, Ludwig-Maximilians-University, Lindwurmstr 4, Munich, Germany. Robert.DallaPozza@med.uni-muenchen.de
Bechtold
Susanne
S
Bonfig
Walter
W
Putzker
Stefanie
S
Kozlik-Feldmann
Rainer
R
Netz
Heinrich
H
Schwarz
Hans-Peter
HP
D000293:Adolescent; D017668:Age of Onset; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000401:mortality; D008137:Longitudinal Studies; D008297:Male; D015203:Reproducibility of Results; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods* / Q000592:standards