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.
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
Jennifer
J
Harrington
Alexia S
AS
Peña
Roger
R
Gent
Craig
C
Hirte
Jennifer
J
Couper
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