title: Association between carotid intima-media thickness, buccodental status, and glycemic control in pediatric type 1 diabetes.
abstract: OBJECTIVE
  To evaluate the association between carotid intima-media thickness, buccodental status, and glycemic control in patients with type 1 diabetes.
  
  
  METHODS
  Cross-sectional study with consecutive cases attended in an outpatient clinic (n = 69). Medical and clinical dental history, HbA1c, lipid profile, treatment period, and daily insulin dosage were recorded. Sociodemographic data and anthropometrical measurements were obtained by standardized questionnaire. Doppler real-time ultrasound was performed by a single experienced vascular radiologist blinded to the study. Assessment of buccodental status was done by the Maxillofacial Unit of the Pediatrics Hospital, and an oral scrape culture was collected.
  
  
  RESULTS
  The mean age was 11.7 ± 3.0 years, with diabetes 5.1 ± 3.3 years. Mean HbA1c was 8.5 ± 1.7%. Primary teeth were present in 52.2% and bacterial plaque in 94.2%. Buccodental conditions featured caries (63.8%), gingivitis (84%), and enamel demineralization (26.1%): white spot lesions (18.8%) and cavitated lesions (7.3%). Bacteria associated with caries were found in 44.1%. Patients in the highest HbA1c tertile (>8.5%) had greater frequency of buccodental conditions and were positive for Streptococcus mutans and Candida albicans; also, cIMT increased and vessel compliance decreased compared to those in the lowest tertile (<7.0%) (p < 0.05).
  
  
  CONCLUSIONS
  More buccodental conditions and carotid intima-media thickness increase appeared in the patients with HbA1c level > 8.5%, suggesting onset of atherosclerosis. The correlation between buccodental status and HbA1c values may indicate the connection between inflammatory states of atherosclerosis and type 1 diabetes.
authors.affiliation: Unidad de Investigación Médica en Epidemiología Clínica, Mexico City, Mexico. ritagomezdiaz@yahoo.com.mx
authors.forename: Rita A
authors.initials: RA
authors.lastname: Gómez-Díaz
authors.forename: Eleazar
authors.initials: E
authors.lastname: Ramírez-Soriano
authors.forename: Janet
authors.initials: J
authors.lastname: Tanus Hajj
authors.forename: Elia
authors.initials: E
authors.lastname: Bautista Cruz
authors.forename: Cesar
authors.initials: C
authors.lastname: Jiménez Galicia
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Villasis-Keever
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Aguilar-Salinas
authors.forename: Niels H
authors.initials: NH
authors.lastname: Wacher
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology / Q000382:microbiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D009059:Mouth Diseases / Q000209:etiology* / Q000382:microbiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human