DETERMINANTS OF CAROTID-ARTERY WALL THICKENING IN YOUNG-PATIENTS WITHTYPE-1 DIABETES-MELLITUS

To investigate associations between early atherosclerosis and possible risk factors for it in young patients with established Type 1 diabete s mellitus (DM), we measured the combined intima-media thickness (IMT) of the common carotid arteries with high resolution ultrasound in 310 young patients (age less than or equal to 40 years, mean 27.9 +/- 6.5 ) with a diabetes duration greater than or equal to 2 years, and in tw o control groups of similar age (control 1:40 healthy subjects, contro l 2: 40 Type 1 DM recently diagnosed patients). Albumin excretion rate and lipids (total cholesterol and triglycerides) were measured and re tinopathy and hypertension (systolic blood pressure > 140 or diastolic blood pressure > 90 mmHg) sought in the patients. Mean maximum IMT wa s 0.52 +/- 0.06 mm in control group 1 and 0.50 +/- 0.05 mm in control group 2 with a mean difference of 0.02 mm (95% CI: -0.01, 0.04). The m ore established Type 1 DM patients had a significantly greater IMT (0. 57 +/- 0.13 mm, p < 0.001) than both control groups. In a subgroup ana lysis, patients with microvascular diabetic complications (n = 99) had a significantly greater IMT (0.63 +/- 0.17 vs 0.55 +/- 0.10 mm, p < 0 .001) than those without (n = 211). In a multiple linear regression an alysis with a significance level of less than or equal to 0.10, the ca rotid artery IMT of our established diabetic patients was related to a ge, male gender, triglycerides and nephropathy, suggesting the latter as the main diabetes-specific risk for intima-media thickening in youn g Type 1 DM patients. (C) 1998 John Wiley & Sons, Ltd.