Arterial Wall Thickening; Children; Type 1 Diabetes
Arterial wall thickening and stiffening in children and adolescents with type 1 diabetes
Mehmet Emre Atabek
a;*; Selim Kurtoglu b; Ozgur Pirgon a; Murat Baykara c
a
Department of Pediatric Endocrinology and Diabetes; School of Medicine; Selcuk University; Konya; Turkey
b
Department of Pediatric Endocrinology and Diabetes; School of Medicine; Erciyes University; Kayseri; Turkey
c
Department of Radiology; School of Medicine; Erciyes University; Kayseri; Turkey
Received 12 November 2005; accepted 9 March 2006
Abstract
Objective:
We evaluated structural and functional characteristics of the common carotid artery (CCA); a marker of early carotid
atherosclerosis; and investigated their relation to metabolic and anthropometric parameters in children and adolescents with type 1
diabetes.
Materials and methods:
Non-invasive ultrasonographic measurements were made in 45 type 1 diabetic patients and 33 controls.
Age; sex; and body mass index were matched between patients and controls. We investigated intima-media thickness (IMT);
compliance; distensibility; diastolic wall stress (DWS) and incremental elastic modulus (IEM) of the CCA. Metabolic and
anthropometric parameters such as serum lipids; plasma glycated haemoglobin; body mass index; waist–hip ratio and blood
pressure were assessed.
Results:
The diabetic patients had significantly higher CCA-IMT than the controls (0.48 0.06 mm versus 0.33 0.07 mm;
p
< 0.001). The diabetic children had significantly higher values than the controls for DWS (1.18 0.29 mmHg 102 versus
0.81
0.25 mmHg 102; p < 0.001) and for IEM (1.26 0.57 mmHg 103 versus 0.77 0.28 mmHg 103; p < 0.001). The
difference was not significant between patients and controls for arterial compliance and for distensibility (
p > 0.05). In a
multivariate regression model for all subjects; diabetic state was the best predictor of IMT (
p < 0.001); DWS ( p < 0.001) and IEM
(
p = 0.001).
Conclusion:
Our results suggested that children and adolescent patients with type 1 diabetes are associated with early impairment
of CCA structure and function and that diabetic state may be the main risk factor for CCAwall stiffening and thickening; which are
of considerable concern as possible early events in the genesis of atheroma.
#
2006 Published by Elsevier Ireland Ltd.
Keywords:
Type 1 diabetes; Early atherosclerosis; Common carotid artery
1. Introduction
Diabetes mellitus is established as an independent
risk factor for cardiovascular morbidity and mortality in
adults and children with type 2 diabetes
[1;2]. Although
it is well known that adolescents with type 1 diabetes are
at risk for developing microvascular disease
[3]; the
effects of diabetes on larger vessels have not been
extensively studied. Large vessel dysfunction and its
www.elsevier.com/locate/diabres
Diabetes Research and Clinical Practice xxx (2006) xxx–xxx
Abbreviations:
CCA; common carotid artery; IMT; intima-media
thickness; DWS; diastolic wall stress; IEM; incremental elastic modulus;
LCSA; lumen cross-sectional area; WCSA; intima-media crosssectional
area; CSC; cross-sectional compliance; CSD; cross-sectional
distensibility; HDL-cholesterol; high-density lipoprotein-cholesterol;
LDL-cholesterol; low-density lipoprotein-cholesterol;
HbA1c; plasma glycated haemoglobin
* Corresponding author at: Selcuk Universitesi Meram Tip Fakultesi;
Cocuk Sagligi ve Hastaliklari; 42080 Konya; Turkey.
Tel.: +90 332 223 63 50; fax: +90 332 223 61 81.
E-mail address:
meatabek@hotmail.com (M.E. Atabek).
0168-8227/$ – see front matter
# 2006 Published by Elsevier Ireland Ltd.
doi:
10.1016/j.diabres.2006.03.004
DIAB-3535; No of Pages 8