ATHEROSCLEROSIS IN CAROTID-ARTERY OF YOUNG IDDM PATIENTS MONITORED BYULTRASOUND HIGH-RESOLUTION B-MODE IMAGING

Ultrasound high-resolution B-mode imaging was used to assess the carot id arteries in 105 patients with insulin-dependent diabetes mellitus ( IDDM), 4-25 years of age, with duration of diabetes ranging horn 0.5-1 7 years, 529 patients with non-insulin-dependent diabetes (NIDDM), 31- 86 years of age, with duration of diabetes ranging hom 0.5-49 years, a nd 104 nondiabetic healthy subjects, 7-76 years of age, to determine t he intimal plus medial thickness (IMT) of the arterial wall. The IMT v alues for IDDM patients 10-19 years of age (0.525 +/- 0.123 mn, n = 68 ) or 20-25 years of age (0.696 +/- 0.124 mn, n = 14) were significantl y greater than those in age-matched nondiabetic subjects (0.444 +/- 0. 057 mn, n = 12, P = 0.01169; 0.538 +/- 0. 098 mn, n = 34, P < 0.00006) . NIDDM patients showed IMT values equivalent to those in normal adult s greater than or equal to 20 years of age. Multiple regression analys is showed that IMT in IDDM patients was positively related to the dura tion of diabetes (P = 0.00061) as web as to age (P = 0.00046). No othe r possible risk factors, such as serum total cholesterol level, serum high-density lipoprotein (HDL)-cholesterol level, serum low-density li poprotein-cholesterol level, serum triglycerides, serum lipoprotein(a) level, or systolic or diastolic blood pressure, have shown significan t correlations with IMT in IDDM patients. However, non-HDL-cholesterol , smoking, and systolic hypertension were independently responsible fo r increases in IMT values of NIDDM patients as well as age and duratio n of diabetes. The partial regression coefficient of IMT for duration of diabetes (0.00978 mm/year) consistent with that of IMT for age (0.0 0848-0.00909 mm/year) in nondiabetic and diabetic subjects indicated t hat diabetes led to carotid atherosclerosis that was twice as advanced in children and adolescents with IDDM. Ultrasound high-resolution B-m ode imaging revealed atherosclerosis in the carotid arteries of young IDDM patients on in vivo examination. Diabetes as well as aging can ad vance atherosclerosis in the carotid arteries of young diabetic patien ts. The IMT of carotid arteries, which can be measured noninvasively a nd frequently, may be an important indicator of atherosclerosis, even in young IDDM patients.