CAROTID ATHEROSCLEROSIS IN ADOLESCENTS AND YOUNG-ADULTS WITH IDDM - RELATION TO URINARY ENDOTHELIN, ALBUMIN, FREE CORTISOL, AND OTHER FACTORS

OBJECTIVE - To investigate 1) alterations of carotid intimal-plus-medi al thickness (IMT) in subjects with IDDM and 2) the relation of IMT to indexes of diabetic angiopathy and to risk factors of atherosclerosis . RESEARCH DESIGN AND METHODS - IMT was assessed by ultrasound B-mode imaging in 39 subjects with IDDM (23 male, 16 female young adults aged 17.5 +/- 5.2 years, diabetes duration 8.8 +/- 5.9) and in 22 control subjects (healthy siblings of the IDDM subjects) of comparable age. Ur inary endothelin (UET1) and urinary free cortisol (UFC) were determine d by radioammunoassay (RIA), urinary albumin by nephelometry, HbA(1c) by high-performance liquid chromatography (HPLC), and plasma renin by immunoradiometric assay (IRMA). RESULTS - The IMT values were greater in IDDM subjects than in control subjects (0.49 +/- 0.1 mm, 0.44 +/- 0 .09 mm, respectively; P = 0.048) and greater in IDDM male subjects tha n in control male subjects (0.52 +/- 0.09 and 0.44 +/- 0.06 mm, respec tively; P = 0.015), with no difference between IDDM and control female subjects. The IMT values were greater in diabetic male subjects than in female subjects (0.52 +/- 0.09 and 0.45 +/- 0.1 mm, respectively; P = 0.017). In IDDM subjects, but not in control subjects, there was a positive correlation of IMT to urinary albumin (P = 0.008), systolic b lood pressure (P = 0.023), UET1 (P = 0.016), UFC (P = 0.002), and BMI (P = 0.021). Multiple regression analysis demonstrated that in IDDM su bjects the variable that interacts independently with IMT was the BMI (P = 0.001). CONCLUSIONS - IMT, an index of atherosclerosis (macroangi opathy), is increased in IDDM subjects quite early (already in adolesc ence), and it is positively related to urinary albumin, UET1, blood pr essure, and UFC.