title: Gender, metabolic control and carotid intima-media-thickness in children and adolescents with type 1 diabetes mellitus.
abstract: BACKGROUND
  Despite a marked improvement in the overall prognosis of patients with type 1 diabetes mellitus (T1DM), cardiovascular morbidity/mortality is still increased. Since cellular and microvascular aberrations have been demonstrated already in children with T1DM, albeit a good glycemic control (CO), we hypothesized that early macrovascular changes can be detected by common carotid artery intima-media thickness (CCA-IMT).
  
  
  METHODS
  We included 73 children/adolescents with T1DM (34 boys, 39 girls; mean age, 14.8 ± 2 years) and 243 sex- and age-matched healthy CO. In T1DM mean HbA1c was 7.9 ± 1.1 rel.%, and duration of disease 7.5 ± 3.1 years. High-resolution ultrasonography was used to assess CCA-IMT, defined as the mean of 24 measurements of the near and far wall on both right and left CCA.
  
  
  RESULTS
  CCA-IMT was not different in the total of children and adolescents with T1DM compared with CO (0.302 ± 0.057 vs. 0.301 ± 0.054 mm; p = 0.88). Analysis according to gender, however, revealed higher CCA-IMT values in girls than in boys in the diabetic cohort (0.315 ± 0.055 vs. 0.288 ± 0.058 mm; p = 0.047), whereas CCA-IMT was higher in boys than in girls in the CO group (0.321 ± 0.057 vs. 0.284 ± 0.045 mm; p < 0.001). Multiple stepwise backward regression showed that in the T1DM group only HbA1c remained significantly associated with CCA-IMT (Beta = - 0.307, p = 0.008). In CO, gender (Beta = - 0.302, p < 0.001), body mass index (Beta = 0.226, p < 0.001) and systolic blood pressure (Beta = 0.213, p < 0.001) were predictive of CCA-IMT.
  
  
  CONCLUSIONS
  Our data suggest that in children/adolescents with T1DM the quality of metabolic CO (HbA1c) is the most important predictor of CCA-IMT and outweighs the effect of gender.
authors.affiliation: Department of Medicine II, Division of Angiology, Medical University & General Hospital Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria, georgiana-aura.giurgea@meduniwien.ac.at.
authors.forename: Georgiana-Aura
authors.initials: GA
authors.lastname: Giurgea
authors.forename: Katrin
authors.initials: K
authors.lastname: Nagl
authors.forename: Michael
authors.initials: M
authors.lastname: Gschwandtner
authors.forename: Clemens
authors.initials: C
authors.lastname: Höbaus
authors.forename: Thomas
authors.initials: T
authors.lastname: Hörtenhuber
authors.forename: Renate
authors.initials: R
authors.lastname: Koppensteiner
authors.forename: Christian
authors.initials: C
authors.lastname: Margeta
authors.forename: Maria
authors.initials: M
authors.lastname: Fritsch
authors.forename: Birgit
authors.initials: B
authors.lastname: Rami-Merhar
authors.forename: Gerit-Holger
authors.initials: GH
authors.lastname: Schernthaner
authors.forename: Oliver
authors.initials: O
authors.lastname: Schlager
authors.forename: Edith
authors.initials: E
authors.lastname: Schober
authors.forename: Sabine
authors.initials: S
authors.lastname: Steiner
authors.forename: Andrea
authors.initials: A
authors.lastname: Willfort-Ehringer
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D001317:Austria / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016896:Treatment Outcome