Adolescents with type 1 diabetes at increased risk for future CV events

ORLANDO — Adolescents with type 1 diabetes have greater baseline carotid intima-media thickness when compared with their siblings without diabetes — thus increasing their risk for future cardiovascular events in adulthood, according to data presented at the ADA 70th Scientific Sessions.

Christina M. Southern Reh, MD, pediatrician in Los Angeles, Calif., and colleagues studied changes in carotid intima-media thickness over time and associated risk factors in young people with diabetes. The study included 345 adolescents who were compared with 88 siblings without type 1 diabetes. The adolescents were mostly white, had a mean diabetes duration of 7 years and a mean baseline HbA1c of 8.7%. Fasting lipids, HbA1c levels, homocysteine, BMI and carotid intima-media thickness were measured every 6 months.

Compared with siblings, baseline carotid intima-media thickness was greater in adolescents with type 1 diabetes (560.3 mcm vs. 542 mcm; P=.002). Further, carotid intima-media thickness increased significantly as both LDL and LDL–HDL ratio increased. When the researchers adjusted for age, BMI z score and race/ethnicity, the relationship between carotid intima-media thickness and LDL–HDL ratio persisted and there was also a link to homocysteine.

The effect of carotid intima-media thickness was more pronounced in girls with total cholesterol levels of 200 mg/dL or greater. Conversely, a similar association was observed with carotid intima-media thickness and triglycerides in boys.

“Hyperlipidemia and homocysteine are modifiable risk factors and determinants of progression in this population,” Southern Reh said during an oral presentation here. “Further long-term studies are needed to look at progression of carotid intima-media thickness and CV disease risk.”

For more information:

Southern Reh CM. 300-OR. Presented at: The American Diabetes Association 70th Scientific Sessions; June 25-29, 2010; Orlando.

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