title: The effect of cardiovascular risk factors on the longitudinal evolution of the carotid intima medial thickness in children with type 1 diabetes mellitus.
abstract: BACKGROUND
  Type 1 diabetes mellitus is a generally accepted atherogenic risk factor. The aim of this prospective longitudinal study was to evaluate changes in carotid intima media thickness (cIMT) in children and adolescents with type 1 diabetes mellitus (T1DM) using standardized methods.
  
  
  METHODS
  We re-evaluated cIMT in 70 (38 f) of initial 150 (80 f) patients with T1DM after 4 years. At re-evaluation, mean (±SD) age was 16.45±2.59 y, mean diabetes duration was 9.2±3.24 y and patients had a mean HbA1c of 8.14±1.06%.
  
  
  RESULTS
  Mean cIMT z-scores increased significantly during 4 years (0.58±0.75, p<0.001) as well as BMI-z-score (0.41±0.81, p<0.01), systolic blood pressure (0.77±1.15, p<0.01) and HbA1c (0.90±1.07, <0.001). In a linear regression model systolic blood pressure z-score at first measurement (0.02, CI: 0.01, 0.04) was a significant predictor for the mean effect on cIMT z-score. In a logistic regression model significant risk factors for an increase in IMT of ≥1.5 z-scores were BMI z-scores (OR: 3.02, CI:1.11, 10.14), diabetes duration (OR:1.32, CI:1.04, 1.77) and systolic blood pressure (OR: 1.14, CI: 1.04, 1.27) at first measurement each.
  
  
  CONCLUSIONS
  Longitudinal cIMT measurements revealed progression in subclinical atherosclerosis during a four year period in diabetic children and adolescents. Systolic blood pressure and BMI were related to cIMT increment. Control of these risk factors by lifestyle and medical intervention may prevent progression of cIMT in diabetic children.
authors.affiliation: Department of Pediatric Cardiology, Ludwig-Maximilians-University, Marchioninistr, 15, D-81377 Munich, Germany. Robert.Dallapozza@med.uni-muenchen.de
authors.forename: Robert
authors.initials: R
authors.lastname: Dalla Pozza
authors.forename: Andreas
authors.initials: A
authors.lastname: Beyerlein
authors.forename: Claude
authors.initials: C
authors.lastname: Thilmany
authors.forename: Claudia
authors.initials: C
authors.lastname: Weissenbacher
authors.forename: Heinrich
authors.initials: H
authors.lastname: Netz
authors.forename: Heinrich
authors.initials: H
authors.lastname: Schmidt
authors.forename: Susanne
authors.initials: S
authors.lastname: Bechtold
mesh_terms: D000293:Adolescent; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography