Aortic intima media thickness is an early marker of atherosclerosis in children with type 1 diabetes mellitus.
OBJECTIVE
To compare aortic intima media thickness (aIMT) to carotid intima media thickness (cIMT) as a marker of early atherosclerosis in children with type 1 diabetes mellitus and to examine the associations of aIMT to known cardiovascular risk factors.


METHODS
66 children with type 1 diabetes mellitus (age, 14.1 +/- 2.5 years; 37 male) and 32 healthy control subjects (age, 14.2 +/- 3 years; 15 male) underwent assessment of vascular structure (cIMT and aIMT) and vascular function (flow mediated dilatation [FMD] and glyceryl trinitrate induced dilatation [GTN]). Fasting blood tests were taken to measure levels of hemoglobin A1c, high sensitive C reactive protein, total homocyst(e)ine, serum folate, red cell folate, and lipids.


RESULTS
aIMT, but not cIMT, was significantly greater in the children with type 1 diabetes mellitus than in control subjects (P < .001). In children with type 1 diabetes mellitus, aIMT correlated with glycosylated hemoglobin (r = 0.31, P = .01) and was independently associated with age (beta = 0.38, P = .001) and low-density lipoprotein cholesterol level (beta = 0.38, P = .001). Vascular function (GTN) was worse in children with type 1 diabetes mellitus who had an aIMT >95th percentile, as defined with the control subjects.


CONCLUSIONS
aIMT is an earlier marker than cIMT of preclinical atherosclerosis in children with type 1 diabetes mellitus and relates to known cardiovascular risk factors and metabolic control.
Harrington
Jennifer
J
Endocrinology and Diabetes Department, University of Adelaide, Women's and Children's Hospital, 72 King William Rd N, Adelaide, SA 5006, Australia. jennifer.harrington@cywhs.sa.gov.au
Peña
Alexia S
AS
Gent
Roger
R
Hirte
Craig
C
Couper
Jennifer
J
D000293:Adolescent; D000367:Age Factors; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology*; D050197:Atherosclerosis / Q000175:diagnosis* / Q000517:prevention & control; D015415:Biomarkers; D017536:Carotid Artery, Common / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D042241:Early Diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D016555:Matched-Pair Analysis; D015999:Multivariate Analysis; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D015415:Biomarkers; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin