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Arterial wall thickening, children, type 1 diabetes
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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
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