title: Predictors of Increased Carotid Intima-Media Thickness in Youth With Type 1 Diabetes: The SEARCH CVD Study.
abstract: OBJECTIVE
  Youth with type 1 diabetes have worse cardiovascular (CV) risk factors and higher carotid intima-media thickness (IMT) than their peers without diabetes. Whether the burden of CV risk factors over time is associated with carotid IMT at follow-up in youth with type 1 diabetes is not known.
  
  
  METHODS
  Two hundred ninety-eight youth with type 1 diabetes (mean age 13.3 ± 2.9 years, 87.6% non-Hispanic white, 53.7% male) had two study visits 5 years apart. CV risk factors, including BMI, lipids, blood pressure, hemoglobin A(1c), and smoking status, were assessed at both visits, and carotid IMT was measured at follow-up using B-mode ultrasonography. Linear regression models with an area under the curve measurement that incorporated the baseline and follow-up CV risk factors were used to evaluate the relationship with carotid IMT at follow-up.
  
  
  RESULTS
  All CV risk factors worsened significantly over time (except LDL cholesterol) (P < 0.05). From baseline to follow-up, the number of abnormal CV risk factors also increased (P < 0.05). Predictors of carotid IMT were older age, male sex, and higher BMI z score area under the curve (all P < 0.05).
  
  
  CONCLUSIONS
  The CV risk factor burden increases over time in youth with type 1 diabetes. BMI z score was the only modifiable CV risk factor that predicted carotid IMT. This study highlights the critical need to better understand the risk factors that influence carotid IMT early in the course of type 1 diabetes.
authors.affiliation: Cincinnati Children's Hospital and Department of Pediatrics, University of Cincinnati, Cincinnati, OH amy.shah@cchmc.org.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Shah
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO.
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Nora F
authors.initials: NF
authors.lastname: Fino
authors.affiliation: Cincinnati Children's Hospital and Department of Pediatrics, University of Cincinnati, Cincinnati, OH.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.
authors.forename: R Paul
authors.initials: RP
authors.lastname: Wadwa
authors.affiliation: Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC.
authors.forename: Ralph
authors.initials: R
authors.lastname: D'Agostino
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO.
authors.forename: Richard
authors.initials: R
authors.lastname: Hamman
authors.affiliation: Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA.
authors.forename: Santica
authors.initials: S
authors.lastname: Marcovina
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.affiliation: Cincinnati Children's Hospital and Department of Pediatrics, University of Cincinnati, Cincinnati, OH.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Urbina
mesh_terms: D000293:Adolescent; D000367:Age Factors; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D003120:Colorado / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009820:Ohio / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult