title: Comparison of the effects of intensive insulin treatment modalities on cardiovascular biomarkers in type 1 diabetes mellitus.
abstract: OBJECTIVE
  To evaluate effects of intensive insulin treatment modalities on cardiovascular biomarkers in patients with type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  A total of 25 patients with T1DM receiving intensive insulin therapy either in the form of continuous insulin pump (IP group; n=13) or as multiple daily injections (MDI group; n=12) and 13 controls (control group, n=13) were included. Data on demographics, anthropometrics, diabetes history, and laboratory findings including glycemic and lipid parameters, and cardiovascular biomarkers [C-reactive protein (mg/dL), homocysteine (μmol/L), fibrinogen (mg/dL), oxidized LDL (ng/dL), PAI-1 (ng/mL), MCP-1 (pg/mL) and VEGF (pg/mL)] were recorded in each group. Correlation of cardiovascular biomarkers to other parameters was also evaluated in T1DM patients.
  
  
  RESULTS
  Apart from significantly higher mean (SD) values for HbA1c [6.1 (0.3) vs. 5.6 (0.5)% (43 (3) vs. 38 (5) mmol/mol), p<0.05)] and HDL-cholesterol [71.5 (13.6) vs. 58.2 (10.8), p<0.01) in the IP than in the MDI group, no significance difference was noted between insulin treatment modalities as well as between patient and control groups in terms of demographic, anthropometric and laboratory parameters. Negative correlation of MCP-1 to treatment duration (r=-0.615, p=0.025), and HDL-c to CRP (r=-0.685, p=0.010) and VEGF (r=-0.678, p=0.011) was noted in IP group, whereas positive correlation of PAI-1 to diabetes age (r=0.805, p=0.002) and treatment duration was noted in MDI group.
  
  
  CONCLUSIONS
  Our findings in a cohort of T1DM patients with optimal glycemic control revealed that intensive insulin therapy was not associated with an increase in atherosclerotic markers in T1DM, regardless of whether continuous IP infusion or MDIs was administered.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Ege University Faculty of Medicine, Izmir, Turkey. Electronic address: scetinkalp@hotmail.com.
authors.forename: Sevki
authors.initials: S
authors.lastname: Cetinkalp
authors.affiliation: Izmir Bozyaka Training and Research Hospital, Izmir, Turkey. Electronic address: cananfelekoglu@yahoo.com.tr.
authors.forename: Canan
authors.initials: C
authors.lastname: Felekoglu
authors.affiliation: Sifa University Faculty of Medicine, Izmir, Turkey. Electronic address: muammerkaradenis@yahoo.com.
authors.forename: Muammer
authors.initials: M
authors.lastname: Karadeniz
authors.affiliation: Department of Statistics, Ege University Faculty of Science, Izmir, Turkey. Electronic address: hayalboyacioglu@yahoo.com.
authors.forename: Hayal
authors.initials: H
authors.lastname: Boyacıoglu
authors.affiliation: Department of Biochemistry, Ege University Faculty of Medicine, Izmir, Turkey. Electronic address: yasemin.akcay@ege.edu.tr.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Delen
authors.affiliation: Department of Biochemistry, Ege University Faculty of Medicine, Izmir, Turkey. Electronic address: eser.yildirim@ege.edu.tr.
authors.forename: Eser
authors.initials: E
authors.lastname: Yildirim
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Ege University Faculty of Medicine, Izmir, Turkey. Electronic address: candeger.yilmaz@ege.edu.tr.
authors.forename: Candeger
authors.initials: C
authors.lastname: Yilmaz
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D018932:Chemokine CCL2 / Q000097:blood; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007332:Insulin Infusion Systems / Q000009:adverse effects; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D007328:Insulin; D008077:Lipoproteins, LDL; D017395:Plasminogen Activator Inhibitor 1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C099252:oxidized low density lipoprotein; D006710:Homocysteine; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: Atherosclerosis; Biomarker; Intensive insulin treatment; Type 1 diabetes mellitus