Intracoronary ultrasound examinations reveal significantly more advanced coronary atherosclerosis in people with type 1 diabetes than in age- and sex-matched non-diabetic controls.
OBJECTIVE
The extent of coronary atherosclerosis is significantly more advanced in symptomatic type 1 diabetes patients than in symptomatic non-diabetic patients. Whether this difference exists between asymptomatic individuals with diabetes and controls is not documented. In vivo imaging techniques allow quantification of the difference at a preclinical stage.


METHODS
The degree of coronary atherosclerosis in early onset type 1 diabetes patients without symptoms of cardiovascular disease was compared with that of age- and sex-matched controls. Intracoronary ultrasound (IVUS) examinations were performed to determine the degree of atherosclerosis. The mean age of the patients was 43 years (35-58), they had a mean duration of disease of 30 (23-39) years and the diagnosis of type 1 diabetes was made at a mean age of 12.5 years. The controls were people with transplanted hearts; donors were sex- and age-matched and had a mean age of 43 (35-58) years.


RESULTS
The degree of subclinical coronary atherosclerosis was significantly more severe in type 1 diabetes patients than in controls. This was the case for all parameters measured. The mean plaque area was >or= 40% in 71% (54/76) of diabetic arteries as opposed to 33% (25/76) of arteries from controls (p<0.0001). The mean plaque thickness was 0.59+/-0.38 mm vs. 0.44+/-0.30 mm in controls (p<0.0001). The mean lumen area was 8.6+/-3.8 mm2 in type 1 diabetes and 12.1+/-4.3 mm2 in controls (p<0.0001).


CONCLUSIONS
Asymptomatic individuals with type 1 diabetes have significantly more advanced subclinical coronary atherosclerosis than controls. Coronary atherosclerosis in type 1 diabetes develops at an early age.
Larsen
Jakob R
JR
Department of Pediatrics and Helse Øst Centre for Health Services, Akershus University Hospital, Lørenskog, Norway. jakob.larsen@medisin.uio.no
Tsunoda
Taro
T
Tuzcu
E Murat
EM
Schoenhagen
Paul
P
Brekke
Magne
M
Arnesen
Harald
H
Hanssen
Kristian F
KF
Nissen
Steven E
SE
Dahl-Jorgensen
Knut
K
D000328:Adult; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D018084:Ultrasonography, Interventional