Determinants of carotid artery wall thickening in young patients with Type 1 diabetes mellitus

Abstract

To investigate associations between early atherosclerosis and possible risk factors for it in young patients with established Type 1 diabetes mellitus (DM), we measured the combined intima-media thickness (IMT) of the common carotid arteries with high resolution ultrasound in 310 young patients (age < or = 40 years, mean 27.9 +/- 6.5) with a diabetes duration > or = 2 years, and in two control groups of similar age (control 1:40 healthy subjects, control 2: 40 Type 1 DM recently diagnosed patients). Albumin excretion rate and lipids (total cholesterol and triglycerides) were measured and retinopathy and hypertension (systolic blood pressure > 140 or diastolic blood pressure > 90 mmHg) sought in the patients. Mean maximum IMT was 0.52 +/- 0.06 mm in control group 1 and 0.50 +/- 0.05 mm in control group 2 with a mean difference of 0.02 mm (95% CI: -0.01, 0.04). The more established Type 1 DM patients had a significantly greater IMT (0.57 +/- 0.13 mm, p < 0.001) than both control groups. In a subgroup analysis, patients with microvascular diabetic complications (n = 99) had a significantly greater IMT (0.63 +/- 0.17 vs 0.55 +/- 0.10 mm, p < 0.001) than those without (n = 211). In a multiple linear regression analysis with a significance level of < or = 0.10, the carotid artery IMT of our established diabetic patients was related to age, male gender, triglycerides and nephropathy, suggesting the latter as the main diabetes-specific risk for intima-media thickening in young Type 1 DM patients.