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Exp Clin Endocrinol Diabetes 2011; 119(5): 281-285
DOI: 10.1055/s-0030-1267184
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Carotid Intima-Media Thickness and Arterial Stiffness in Type 1 Diabetic Patients are Dependent on Age and Mean Blood Pressure

A. Rogowicz-Frontczak1 , A. Araszkiewicz1 , S. Pilacinski1 , D. Zozulinska-Ziolkiewicz1 , A. Wykretowicz2 , B. Wierusz-Wysocka1
  • 1Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland
  • 2Department of Internal Medicine, Division of Cardiology-Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
Further Information

Publication History

received 11.06.2010 first decision 10.09.2010

accepted 15.09.2010

Publication Date:
28 October 2010 (online)

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Abstract

Aim: The aim of the study was to assess the factors that influence carotid intima-media thickness (CIMT) and arterial stiffness in type 1 diabetic patients.

Material and Methods: We included 87 type 1 diabetic patients (44 women, 43 men), median age 34 years, disease duration 10 years, HbA1c 8.2%. CIMT was measured using high resolution ultrasonography. Arterial stiffness was assessed with the use of digital volume pulse analysis and tonometric measurement of wave reflection and central haemodynamics. Serum C-reactive protein (hsCRP), matrix metalloproteinase-9 (MMP-9), soluble intracellular adhesion molecule-1 (sICAM-1) and myeloperoxidase (MPO) concentrations were also measured.

Results: CIMT and arterial stiffness correlated with age, duration of diabetes, systolic and diastolic blood pressure, GFR-glomerular filtration rate and sICAM-1. Multiple regression analysis identified only age as significant determinant of CIMT. Age, mean blood pressure and GFR, but not duration of diabetes were significant determinants of arterial stiffness.

Conclusions: In type 1 diabetic patients both CIMT and arterial stiffness were related to age, blood pressure, kidney function and sICAM-1 serum concentration.

Key words

type 1 diabetes - carotid intima-media thickness - arterial stiffness - sICAM-1

References

  • 1 Berry KL, Skyrme-Jones RA, Cameron JD. et al . Systemic arterial compliance is reduced in young patients with IDDM.  Am J Physiol. 1999;  276 ((6)) 1839-1845
    Google Scholar
  • 2 Bulpitt CJ, Cameron JD, Rajkumar C. et al . The effect of age on vascular compliance in man: which are the appropriate measures?.  J Hum Hypertens. 1999;  13 ((11)) 753-758
    Google Scholar
  • 3 Cheng HM, Ye ZX, Chiou KR. et al . Vascular stiffness in familial hypercholesterolaemia is associated with C-reactive protein and cholesterol burden.  Eur J Clin Invest. 2007;  37 ((3)) 197-206
    Google Scholar
  • 4 Coccheri S. Approaches to prevention of cardiovascular complications and events in diabetes mellitus.  Drugs. 2007;  67 ((7)) 997-1026
    Google Scholar
  • 5 Cohn JN, Quyyumi AA, Hollenberg NK. et al . Surrogate markers for cardiovascular disease: functional markers.  Circulation. 2004;  109 ((25)) 31-46
    Google Scholar
  • 6 Devaraj S, Dasu MR, Jialal I. Diabetes is a proinflammatory state: a translational perspective.  Expert Rev Endocrinol Metab. 2010;  5 ((1)) 19-28
    Google Scholar
  • 7 Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group . Effect of intensive diabetes treatment on carotid artery wall thickness in the epidemiology of diabetes interventions and complications.  Diabetes. 1999;  48 ((2)) 383-390
    Google Scholar
  • 8 Gul K, Ustun I, Aydin Y. et al . Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus.  Anadolu Kardiyol Derg. 2010;  10 52-58
    Google Scholar
  • 9 Jensen-Urstad KJ, Reichard PG, Rosfors JS. et al . Early atherosclerosis is retarded by improved long-term blood glucose control in patients with IDDM.  Diabetes. 1996;  45 ((9)) 1253-1258
    Google Scholar
  • 10 Kampus P, Kals J, Ristimae T. et al . Augmentation index and carotid intima-media thickness are differently related to age, C-reactive protein and oxidized low-density lipoprotein.  J Hypertens. 2007;  25 ((4)) 819-825
    Google Scholar
  • 11 Kannel WB, McGee DL. Diabetes and glucose tolerance as risk factors for cardiovascular disease: the Framingham study.  Diabetes Care. 1979;  2 ((2)) 120-126
    Google Scholar
  • 12 Karamitsos TD, Karvounis HI, Didangellos TP. et al . Usefulness of colour tissue Doppler imaging in assessing aortic elastic properties in Type 1 diabetic patients.  Diabet Med. 2006;  23 ((11)) 1201-1206
    Google Scholar
  • 13 Kim JS, Kang TS, Kim JB. et al . Significant association of C-reactive protein with arterial stiffness in treated non-diabetic hypertensive patients.  Atherosclerosis. 2007;  192 ((2)) 401-406
    Google Scholar
  • 14 Knudsen ST, Poulsen PL, Hansen KW. et al . Pulse pressure and diurnal blood pressure variation: association with micro- and macrovascular complications in type 2 diabetes.  Am J Hypertens. 2002;  15 ((3)) 244-250
    Google Scholar
  • 15 Koivisto VA, Stevens LK, Mattock M. et al . Cardiovascular disease and its risk factors in IDDM in Europe EURODIAB IDDM Complications Study Group.  Diabetes Care. 1996;  19 ((7)) 689-697
    Google Scholar
  • 16 Larsen JR, Brekke M, Bergengen L. et al . Mean HbA1c over 18 years predicts carotid intima media thickness in women with type 1 diabetes.  Diabetologia. 2005;  48 ((4)) 776-779
    Google Scholar
  • 17 Lawson C, Wolf S. ICAM-1 signaling in endothelial cells.  Pharmacol Rep. 2009;  61 ((1)) 22-32
    Google Scholar
  • 18 Nagano M, Nakamura M, Sato K. et al . Association between serum C-reactive protein levels and pulse wave velocity: a population-based cross-sectional study in a general population.  Atherosclerosis. 2005;  180 ((1)) 189-195
    Google Scholar
  • 19 Nathan DM, Lachin J, Cleary P. et al . Diabetes Control and Complications Trial; Epidemiology of Diabetes Interventions and Complications Research Group. Intensive Diabetes Therapy and Carotid Intima-Media Thickness in Type 1 Diabetes Mellitus.  N Engl J Med. 2003;  348 ((23)) 2294-2303
    Google Scholar
  • 20 Ogawa Y, Uchigata Y, Iwamoto Y. Progression Factors of Carotid Intima-Media Thickness and Plaque In Patients with Long-Term, Early-Onset Type 1 Diabetes Mellitus In Japan: Simultaneous Comparison with Diabetic Retinopathy.  J Atheroscler Thromb. 2009;  16 ((6)) 821-828
    Google Scholar
  • 21 Oliver JJ, Webb DJ. Noninvasive assessment of arterial stiffness and risk of atherosclerotic events.  Arterioscler Thromb Vasc Biol. 2003;  23 ((4)) 554-566
    Google Scholar
  • 22 Orchard TJ, Olson JC, Erbey JR. et al . Insulin resistance-related factors, but not glycemia, predict coronary artery disease in type 1 diabetes: 10-year follow-up data from the Pittsburgh Epidemiology of Diabetes Complications Study.  Diabetes Care. 2003;  26 ((5)) 1374-1379
    Google Scholar
  • 23 Payne RA, Wilkinson IB, Webb DJ. Arterial stiffness and hypertension: emerging concepts.  Hypertension. 2010;  55 ((1)) 9-14
    Google Scholar
  • 24 Pujia A, Gnasso A, Irace C. et al . Common carotid arterial wall thickness in NIDDM subjects.  Diabetes Care. 1994;  17 ((11)) 1330-1336
    Google Scholar
  • 25 Reasner CA. Reducing cardiovascular complications of type 2 diabetes by targeting multiple risk factors.  J Cardiovasc Pharmacol. 2008;  52 ((2)) 136-144
    Google Scholar
  • 26 Rema M, Mohan V, Deepa R. et al . Association of carotid intima-media thickness and arterial stiffness with diabetic retinopathy: the Chennai Urban Rural Epidemiology Study (CURES-2).  Diabetes Care. 2004;  27 1962-1967
    Google Scholar
  • 27 Ruderman NB, Haudenschild C. Diabetes as an atherogenic factor.  Prog Cardiovasc Dis. 1984;  26 ((5)) 373-412
    Google Scholar
  • 28 Safar ME, Levy BI, Struijker-Boudier H. Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases.  Circulation. 2003;  107 ((22)) 2864-2869
    Google Scholar
  • 29 Schram MT, Chaturvedi N, Schalkwijk CG. et al . Markers of inflammation are cross-sectionally associated with microvascular complications and cardiovascular disease in type 1 diabetes – the EURODIAB Prospective Complications Study.  Diabetologia. 2005;  48 ((2)) 370-378
    Google Scholar
  • 30 Soedamah-Muthu SS, Chaturvedi N, Toeller M. et al . Risk factors for coronary heart disease in type 1 diabetic patients in Europe: the EURODIAB Prospective Complications Study.  Diabetes Care. 2004;  27 ((2)) 530-537
    Google Scholar
  • 31 van Hecke MV, Dekker JM, Stehouwer CD. et al . Diabetic retinopathy is associated with mortality and cardiovascular disease incidence: the EURODIAB prospective complications study.  Diabetes Care. 2005;  28 ((6)) 1383-1389
    Google Scholar
  • 32 Wakabayashi I, Masuda H. Association of acute-phase reactants with arterial stiffness in patients with type 2 diabetes mellitus.  Clin Chim Acta. 2006;  365 ((1–2)) 230-235
    Google Scholar
  • 33 Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes.  J Clin Invest. 2005;  115 ((5)) 1111-1119
    Google Scholar
  • 34 Wilkinson IB, MacCallum H, Rooijmans DF. et al . Increased augmentation index and systolic stress in type 1 diabetes mellitus.  QJM. 2000;  93 ((7)) 441-448
    Google Scholar
  • 35 Wykretowicz A, Adamska K, Guzik P. et al . Indices of vascular stiffness and wave reflection in relation to body mass index or body fat in healthy subjects.  Clin Exp Pharmacol Physiol. 2007;  34 ((10)) 1005-1009
    Google Scholar
  • 36 Wykretowicz A, Gerstenberger P, Guzik P. et al . Arterial stiffness in relation to subclinical atherosclerosis.  Eur J Clin Invest. 2009;  39 ((1)) 11-16
    Google Scholar

Correspondence

A. Araszkiewicz

Department of Internal Medicine and Diabetology

Poznan University of Medical Sciences

Mickiewicza 2

60-834 Poznan

Poland

Phone: +48/61/847 4579

Fax: +48/61/847 4579

Email: olaaraszkiewicz@interia.pl

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