Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus.
OBJECTIVE
Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy).


METHODS
One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student's t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis.


RESULTS
Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70+/-0.11 mm) compared with the patients without complications (0.63+/-0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009).


CONCLUSIONS
Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM.
Department of Endocrinology and Metabolism, Ankara Atatürk Education and Research Hospital, Ankara, Turkey.
Kamile
K
Gül
Ihsan
I
Ustün
Yusuf
Y
Aydin
Dilek
D
Berker
Kutlu
K
Erol
Mustafa
M
Unal
Ayşe Ozden
AO
Barazi
Tuncay
T
Delibaşi
Serdar
S
Güler
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D050197:Atherosclerosis / Q000453:epidemiology* / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000150:complications; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D055815:Young Adult