title: Influence of a family history of type 2 diabetes, demographic and clinical data on carotid intima-media thickness in patients with type 1 diabetes: a cross-sectional study.
abstract: BACKGROUND
  Intima-media thickness (IMT) of the common carotid artery is a surrogate end point of cardiovascular disease (CVD). Identifying the factors associated with a higher IMT may contribute to the identification of subjects with higher CVD risk. Our objective was to compare the common carotid IMT of type 1 diabetes patients to healthy control subjects. The secondary objective was to determine factors associated with a higher carotid IMT.
  
  
  METHODS
  We conducted a cross-sectional study between March 2009 and October 2013, comprising 127 type 1 diabetes patients and 125 control subjects matched by age, gender and body mass index (BMI). Carotid IMT was measured using semi-automated edge detection software.
  
  
  RESULTS
  Type 1 diabetes patients had a higher median IMT compared with control subjects (0.538; IQR: 0.500-0.607 vs 0.513 mm; IQR: 0.481-0.557, respectively p = 0.001). Women with type 1 diabetes had a higher median IMT difference compared to the control group (0.537; IQR: 0.495-0.596 vs 0.502 mm; IQR: 0.472-0.543, respectively p = 0.003) than did men with type 1 diabetes (0.547; IQR: 0.504-0.613 vs 0.528 mm; IQR: 0.492-0.575, respectively p = 0.2). Age and diabetes duration had an additive effect on the IMT of type 1 diabetes patients. Multivariate gamma regression model analysis showed that in type 1 diabetes patients, the IMT was associated with age (Exp (β) = 1.006, p < 0.001), duration of diabetes (Exp (β) = 1.004, p = 0.001), BMI (Exp (β) = 1.005, p = 0.021), family history of type 2 diabetes (Exp (β) = 1.044, p = 0.033), total cholesterol (Exp (β) = 0.999, p = 0.001) and creatinine clearance (Exp (β) = 1.000, p = 0.043).
  
  
  CONCLUSIONS
  Patients with type 1 diabetes have increased IMT, a marker of subclinical atherosclerosis. The CVD risk may be similar between men and women with type 1 diabetes, suggesting a loss of gender protection. Also, CVD risk may be higher in those with a family history of type 2 diabetes. Prospective studies are needed to confirm the predictive value of these findings and the causal effect between IMT and CVD in patients with type 1 diabetes.
authors.affiliation: Endocrinology Department at University Hospital of Fluminense Federal University, Rio de Janeiro, Brazil, and at Diabetes Unit, State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil. carlosjr.andrade@gmail.com.
authors.forename: Carlos Roberto Moraes
authors.initials: CR
authors.lastname: de Andrade Junior
authors.forename: Eliete Leão Clemente
authors.initials: EL
authors.lastname: Silva
authors.forename: Maria de Fátima Bevilaqua
authors.initials: Mde F
authors.lastname: da Matta
authors.forename: Marcia Bueno
authors.initials: MB
authors.lastname: Castier
authors.forename: Maria Luiza Garcia
authors.initials: ML
authors.lastname: Rosa
authors.forename: Marília de Brito
authors.initials: MB
authors.lastname: Gomes
mesh_terms: D000293:Adolescent; D000328:Adult; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000235:genetics*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013223:Statistics as Topic / Q000379:methods; D055815:Young Adult