Carotid artery distensibility and cardiac function in adolescents with type 1 diabetes

Objective: To determine the presence and correlates of early heart and bloo d vessel dysfunction in adolescents with type 1 diabetes mellitus (DM) of r elatively short duration. Study design: A total of 33 patients with DM (20 male, mean age 15.8 +/- 1. 3 years, mean DM duration 9.3 +/- 3.9 years) and 16 healthy subjects in a n ondiabetic control group (7 male, mean age 17.4 +/- 1.7 years) underwent (1 ) ultrasonography of the right carotid artery to assess distensibility, com pliance, and intimal-medial thickness (IMT). (2) echocardiographic assessme nt of systolic and diastolic ventricular function, (3) lipid profile and he moglobin A(1c), and (4) overnight timed urine collections for albumin excre tion rate. Results: Ultrasonography showed significantly lower carotid artery distensi bility in the DM group (38.5 +/- 8.2 x 10(-3) vs 46.5 +/- 11.7 x 10(-3)/kPa , P = .01) but no difference in compliance (14.0 +/- 3.4 x 10(-7) vs 15.8 /- 2.9 x 10(-7)m(2)/kPa, P = .08) or IMT (0.061 +/- 0.013 vs 0.060 +/- 0.01 4 cm, P = .77). Left ventricular (LV) end-diastolic diameter, LV posterior wall thickness, end-systolic wall stress, shortening fraction, ejection fra ction, LV mass, and diastolic function were similar in both groups. Total c holesterol, low density lipoprotein, high density lipoprotein, triglyceride s, and blood pressure were also similar. The median albumin excretion rate was 4.8 mug/min in the DM group (range 1.1 to 19.2) and 3.0 mug/min in the control group (range 1.4 to 5.8) (P = .03). Hemoglobin A(1c) correlated inv ersely with both distensibility (r = -.43, P = .02) and compliance (r = -.3 9, P = .032). Conclusions: This study indicates that early changes in macrovascular funct ion, namely lower carotid artery distensibility, may precede abnormalities in cardiac function or in arterial IMT in adolescents with short duration t ype 1 DM. It also supports a relationship between hyperglycemia and carotid artery dysfunction.