title: [Chronic complications in type 1 diabetes mellitus. Analysis of a cohort of 291 patients with a mean evolution time of 15 years].
abstract: OBJECTIVE
  Micro- and macrovascular complications are the main cause of morbidity and mortality in type 1 diabetes mellitus (T1D). Given the scarcity of data on the subject in our population, we have analyzed the prevalence of vascular complications and possible risk factors in a cohort of T1D patients.
  
  
  METHODS
  A cross-sectional study including patients aged 18 and over diagnosed of T1D with at least 6 months' evolution, seen in the Hospital del Mar, Barcelona and Hospital de Granollers during 2008 was carried out.
  
  
  RESULTS
  We recruited 291 patients (166 men) with a mean age of 38 years and a T1D duration of 15.3 years. There was one or more diabetes-related vascular complications in 110 (37.8%) patients. Of these, 104 (35.7%) had microvascular complications, 22 (7.6%) macrovascular, and 16 (5.5%) both. Patients with microvascular complications had a higher prevalence of tobacco use (57% smokers Vs. 47.5%, P<.05), dyslipidemia (65.4% Vs. 28.3%, P <.05), hypertension (43.3% Vs. 23.5%, P <.05) and metabolic syndrome (41.3% Vs. 18.7%, P<.001). Moreover, they were older, had a longer duration of diabetes and higher values of glycosylated hemoglobin, triglycerides and systolic blood pressure. In the logistic regression analysis, diabetes duration (OR: 1.19 [95%CI: 1.07-1.32], P=.002), glycosylated hemoglobin levels (OR: 3.33 [95%CI: 1.58-7.03], P=.002) and the absence of metabolic syndrome (OR: 0.04 [95% CI:0.002-0.72], P=.03) showed an independent association with microangiopathy. Patients with T1D and macroangiopathy had longer diabetes duration (23.3±12.6 years Vs. 14.7±10.9 years, in patients without complications, P <.001), higher prevalence of metabolic syndrome (50% Vs. 24.9%, in patients without complications, P=.011) and were more frequently receiving lipid lowering treatment (59.1% Vs. 27.1%, in patients without complications, P=.002). In the multiple regression model, only diabetes duration (OR: 1.047 [95% CI: 1.01-1.09], P=.019) remained independently associated with macroangiopathy.
  
  
  CONCLUSIONS
  More than 1/3 of the T1D patients suffered a diabetes-related complication, mainly microvascular, at the time of the study. Diabetes duration and metabolic syndrome are the two mostly strongly related factors to chronic complications of DM1.
authors: Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, España. jchillaron@parcdesalutmar.cat
authors: J J
authors: JJ
authors: Chillarón
authors: M P
authors: MP
authors: Sales
authors: E
authors: E
authors: Sagarra
authors: I
authors: I
authors: Castells
authors: D
authors: D
authors: Benaiges
authors: J A
authors: JA
authors: Flores Le-Roux
authors: J
authors: J
authors: Pedro-Botet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult