Assessment of coronary artery calcification using dual-source computed tomography in adult asymptomatic patients with type 1 diabetes mellitus.
BACKGROUND
Experience with dual-source computed tomography (DSCT) for detecting coronary artery calcification (CAC) in patients with type 1 diabetes is limited.


METHODS
A non-contrast DSCT scan was acquired in 46 type 1 diabetic patients. All scans were suitable for evaluating CAC expressed in Agatston-scores (effective radiation dose 0.66 [0.59-0.81] mSv; median [interquartile range]).


RESULTS
In 21 patients Agatston scores were > or =1 (range 1-2353), while 25 patients had no detectable calcium deposits in the coronary arteries. Patients with vs. without CAC had higher age (52 [44-59] vs. 41 [38-48] yrs; p=0.0045), longer duration of diabetes (25.3 [23.4-36.3] vs. 23.3 [15.7-30.4] yrs; p=0.0238), greater waist circumference (88 [77-98] vs. 79 [75-87] cm; p=0.0147) and BMI (26.7 [24.5-28.4] vs. 22.6 [21.7-25.6] kg/m(2); p=0.0109). Moreover, patients with vs. without detectable CAC had higher serum LDL-cholesterol (3.35 [3.15-3.53] vs. 2.92 [2.62-3.33] mmol/l; p=0.0069) and serum uric acid values (236 [191-266] vs. 200 [170-219] micromol/l; p=0.0437). Hypertension was more frequent (p=0.0144) in patients with than without CAC. The 2 subgroups did not differ in long-term average HbA1c values (7.97 [7.30-8.56] vs. 8.06 [7.24-9.05]%; p=0.7491); however, estimated insulin sensitivity (estimated glucose disposal rate) was lower in patients with vs. without detectable CAC (7.43 [5.73-8.58] vs. 9.24 [8.22-10.72] mg/kg/min; p=0.0017).


CONCLUSIONS
Non-invasive detection of CAC is feasible with a low dose DSCT scan. CAC in type 1 diabetic patients is associated with cardiovascular risk factors rather than with long-term glycemic control.
Maurovich-Horvat
Pál
P
Semmelweis University, Heart Center, Budapest, Hungary.
Móri
Teréz
T
Kerecsen
Gábor
G
Fövényi
József
J
Sallai
Tamás
T
Soós
Pál
P
Préda
István
I
Merkely
Béla
B
Jermendy
György
G
D000328:Adult; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*