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Open Access Highly Accessed Original investigation

Influence of a family history of type 2 diabetes, demographic and clinical data on carotid intima-media thickness in patients with type 1 diabetes: a cross-sectional study

Carlos Roberto Moraes de Andrade17*, Eliete Leão Clemente Silva2, Maria de Fátima Bevilaqua da Matta3, Marcia Bueno Castier4, Maria Luiza Garcia Rosa5 and Marília de Brito Gomes6

Author Affiliations

1 Endocrinology Department at University Hospital of Fluminense Federal University, Rio de Janeiro, Brazil, and at Diabetes Unit, State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil

2 Technical Nursing at Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil

3 Biologist at Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil

4 Department of Internal Medicine, Cardiology Unit, State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil

5 Epidemiology and Biomaths at University Hospital of Fluminense Federal University, Rio de Janeiro, Brazil

6 Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil

7 Rua Ignez Peixoto 565 casa 6, Itaipú, Niterói, Rio de Janeiro, Brazil

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Cardiovascular Diabetology 2014, 13:87  doi:10.1186/1475-2840-13-87

Published: 3 May 2014

Abstract

Background

Intima-media thickness (IMT) of the common carotid artery is a surrogate end point of cardiovascular disease (CVD). Identifying the factors associated with a higher IMT may contribute to the identification of subjects with higher CVD risk. Our objective was to compare the common carotid IMT of type 1 diabetes patients to healthy control subjects. The secondary objective was to determine factors associated with a higher carotid IMT.

Methods

We conducted a cross-sectional study between March 2009 and October 2013, comprising 127 type 1 diabetes patients and 125 control subjects matched by age, gender and body mass index (BMI). Carotid IMT was measured using semi-automated edge detection software.

Results

Type 1 diabetes patients had a higher median IMT compared with control subjects (0.538; IQR: 0.500-0.607 vs 0.513 mm; IQR: 0.481-0.557, respectively p = 0.001). Women with type 1 diabetes had a higher median IMT difference compared to the control group (0.537; IQR: 0.495-0.596 vs 0.502 mm; IQR: 0.472-0.543, respectively p = 0.003) than did men with type 1 diabetes (0.547; IQR: 0.504-0.613 vs 0.528 mm; IQR: 0.492-0.575, respectively p = 0.2). Age and diabetes duration had an additive effect on the IMT of type 1 diabetes patients. Multivariate gamma regression model analysis showed that in type 1 diabetes patients, the IMT was associated with age (Exp (β) = 1.006, p < 0.001), duration of diabetes (Exp (β) = 1.004, p = 0.001), BMI (Exp (β) = 1.005, p = 0.021), family history of type 2 diabetes (Exp (β) = 1.044, p = 0.033), total cholesterol (Exp (β) = 0.999, p = 0.001) and creatinine clearance (Exp (β) = 1.000, p = 0.043).

Conclusions

Patients with type 1 diabetes have increased IMT, a marker of subclinical atherosclerosis. The CVD risk may be similar between men and women with type 1 diabetes, suggesting a loss of gender protection. Also, CVD risk may be higher in those with a family history of type 2 diabetes. Prospective studies are needed to confirm the predictive value of these findings and the causal effect between IMT and CVD in patients with type 1 diabetes.

Keywords:
Type 1 diabetes; Carotid IMT; CVD risk; Women with type 1 diabetes; Family history of type 2 diabetes