Aortic intima media thickness is an early marker of atherosclerosis in children with type 1 diabetes mellitus

J Pediatr. 2010 Feb;156(2):237-41. doi: 10.1016/j.jpeds.2009.08.036. Epub 2009 Oct 23.

Abstract

Objective: To compare aortic intima media thickness (aIMT) to carotid intima media thickness (cIMT) as a marker of early atherosclerosis in children with type 1 diabetes mellitus and to examine the associations of aIMT to known cardiovascular risk factors.

Study design: 66 children with type 1 diabetes mellitus (age, 14.1 +/- 2.5 years; 37 male) and 32 healthy control subjects (age, 14.2 +/- 3 years; 15 male) underwent assessment of vascular structure (cIMT and aIMT) and vascular function (flow mediated dilatation [FMD] and glyceryl trinitrate induced dilatation [GTN]). Fasting blood tests were taken to measure levels of hemoglobin A1c, high sensitive C reactive protein, total homocyst(e)ine, serum folate, red cell folate, and lipids.

Results: aIMT, but not cIMT, was significantly greater in the children with type 1 diabetes mellitus than in control subjects (P < .001). In children with type 1 diabetes mellitus, aIMT correlated with glycosylated hemoglobin (r = 0.31, P = .01) and was independently associated with age (beta = 0.38, P = .001) and low-density lipoprotein cholesterol level (beta = 0.38, P = .001). Vascular function (GTN) was worse in children with type 1 diabetes mellitus who had an aIMT >95th percentile, as defined with the control subjects.

Conclusions: aIMT is an earlier marker than cIMT of preclinical atherosclerosis in children with type 1 diabetes mellitus and relates to known cardiovascular risk factors and metabolic control.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / pathology*
  • Atherosclerosis / diagnosis*
  • Atherosclerosis / prevention & control
  • Biomarkers
  • Carotid Artery, Common / pathology
  • Case-Control Studies
  • Child
  • Cholesterol, LDL / blood
  • Diabetes Mellitus, Type 1 / complications*
  • Early Diagnosis
  • Female
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Linear Models
  • Male
  • Matched-Pair Analysis
  • Multivariate Analysis
  • Risk Factors
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / pathology*
  • Ultrasonography

Substances

  • Biomarkers
  • Cholesterol, LDL
  • Glycated Hemoglobin A