Skip to main content
Home
Zeitschriften
Zeitungen
Podcast
Gesundheitspolitik
Praxis
Allerlei
Jobs
Fachgebiete
Allgemeinmedizin Anästhesiologie & Intensivmedizin Apotheke Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kinder & Jugendheilkunde Neurologie & Psychiatrie Orthopädie & Unfallchirurgie Pflege Urologie Zahnmedizin
Subfächer Innere Medizin
Diabetologie Gastroenterologie Infektiologie Kardiologie Onkologie und Hämatologie Pneumologie Rheumatologie
Fortbildungen
Überblick Fortbildungen DFP-Literaturstudium-Artikel DFP-Webcast Fortbildungen DFP-Podcasts
Erweiterte Suche
Anmelden
nach oben
Wiener klinische Wochenschrift
Erschienen in:

01.02.2015 | original article

Gender, metabolic control and carotid intima-media-thickness in children and adolescents with type 1 diabetes mellitus

verfasst von: Georgiana-Aura Giurgea, MD, Katrin Nagl, MD, Michael Gschwandtner, MD, Clemens Höbaus, MD, Thomas Hörtenhuber, MD, Renate Koppensteiner, MD, Christian Margeta, MD, Maria Fritsch, MD, Birgit Rami-Merhar, MD, Gerit-Holger Schernthaner, MD, Oliver Schlager, MD, Edith Schober, MD, Sabine Steiner, MD, Andrea Willfort-Ehringer, MD

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 3-4/2015

Einloggen, um Zugang zu erhalten

Summary Background Methods Results Conclusion

Despite a marked improvement in the overall prognosis of patients with type 1 diabetes mellitus (T1DM), cardiovascular morbidity/mortality is still increased. Since cellular and microvascular aberrations have been demonstrated already in children with T1DM, albeit a good glycemic control (CO), we hypothesized that early macrovascular changes can be detected by common carotid artery intima-media thickness (CCA-IMT).
We included 73 children/adolescents with T1DM (34 boys, 39 girls; mean age, 14.8 ± 2 years) and 243 sex- and age-matched healthy CO. In T1DM mean HbA1c was 7.9 ± 1.1 rel.%, and duration of disease 7.5 ± 3.1 years. High-resolution ultrasonography was used to assess CCA-IMT, defined as the mean of 24 measurements of the near and far wall on both right and left CCA.
CCA-IMT was not different in the total of children and adolescents with T1DM compared with CO (0.302 ± 0.057 vs. 0.301 ± 0.054 mm; p = 0.88). Analysis according to gender, however, revealed higher CCA-IMT values in girls than in boys in the diabetic cohort (0.315 ± 0.055 vs. 0.288 ± 0.058 mm; p = 0.047), whereas CCA-IMT was higher in boys than in girls in the CO group (0.321 ± 0.057 vs. 0.284 ± 0.045 mm; p < 0.001). Multiple stepwise backward regression showed that in the T1DM group only HbA1c remained significantly associated with CCA-IMT (Beta = − 0.307, p = 0.008). In CO, gender (Beta = − 0.302, p < 0.001), body mass index (Beta = 0.226, p < 0.001) and systolic blood pressure (Beta = 0.213, p < 0.001) were predictive of CCA-IMT.
Our data suggest that in children/adolescents with T1DM the quality of metabolic CO (HbA1c) is the most important predictor of CCA-IMT and outweighs the effect of gender.
Vorheriger Artikel The possible impact of the German DRGs reimbursement system on end-of-life decision making in a surgical intensive care unit
Nächster Artikel Public (Skin) Health perspectives of gender differences in tanning habits and sun protective behaviour: a cross-sectional questionnaire survey
Literatur
1.
Nathan DM, Cleary PA, Backlund JY, et al. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353:2643–53.CrossRefPubMed
2.
Pambianco G, Costacou T, Ellis D, et al. The 30-year natural history of type 1 diabetes complications: the Pittsburgh Epidemiology of Diabetes Complications Study experience. Diabetes. 2006;55:1463–9.CrossRefPubMed
3.
Soedamah-Muthu SS, Fuller JH, Mulnier HE, et al. All-cause mortality rates in patients with type 1 diabetes mellitus compared with a non-diabetic population from the UK general practice research database, 1992–1999. Diabetologia. 2006;49:660–6.CrossRefPubMed
4.
Waernbaum I, Blohmé G, Ostman J, et al. Excess mortality in incident cases of diabetes mellitus aged 15–34 years at diagnosis: a population-based study (DISS) in Sweden. Diabetologia. 2006;49:653–9.CrossRefPubMed
5.
Secrest AM, Becker DJ, Kelsey SF, et al. All-cause mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes: the Allegheny County type 1 diabetes registry. Diabetes Care. 2010;33:2573–9.CrossRefPubMedCentralPubMed
6.
Groop PH, Thomas MC, Moran JL, et al. FinnDiane Study Group. The presence and severity of chronic kidney disease predicts all-cause mortality in type 1 diabetes. Diabetes. 2009;58:1651–8.CrossRefPubMedCentralPubMed
7.
Dogra G, Rich L, Stanton K, Watts GF. Endothelium-dependent and independent vasodilation studies at normoglycaemia in type I diabetes mellitus with and without microalbuminuria. Diabetologia. 2001;44:593–01.CrossRefPubMed
8.
Devaraj S, Cheung AT, Jialal I, et al. Evidence of increased inflammation and microcirculatory abnormalities in patients with type 1 diabetes and their role in microvascular complications. Diabetes. 2007;56:2790–6.CrossRefPubMedCentralPubMed
9.
Lopes-Virella MF, Carter RE, Gilbert GE, et al. Diabetes Control and Complications Trial/Epidemiology of Diabetes Intervention and Complications Cohort Study Group. Risk factors related to inflammation and endothelial dysfunction in the DCCT/EDIC cohort and their relationship with nephropathy and macrovascular complications. Diabetes Care. 2008;31:2006–12.CrossRefPubMedCentralPubMed
10.
Lin J, Glynn RJ, Rifai N, et al. Inflammation and progressive nephropathy in type 1 diabetes in the diabetes control and complications trial. Diabetes Care. 2008;31:2338–43.CrossRefPubMedCentralPubMed
11.
Hörtenhuber T, Rami-Mehar B, Satler M, et al. Endothelial progenitor cells are related to glycemic control in children with type 1 diabetes mellitus over time. Diabetes Care. 2013;36:1647–53.CrossRefPubMedCentralPubMed
12.
Schlager O, Hammer A, Willfort-Ehringer A, et al. Microvascular autoregulation in children and adolescents with type 1 diabetes mellitus. Diabetologia. 2012;55:1633–40.CrossRefPubMed
13.
Berger E, Sochett EB, Peirone A, et al. Cardiac and vascular function in adolescents and young adults with type 1 diabetes. Diabetes Technol Ther. 2004;6:129–35.CrossRefPubMed
14.
Lande MB, Carson NL, Roy J, et al. Effects of childhood primary hypertension on carotid intima media thickness: a matched controlled study. Hypertension. 2006;48:40–4.CrossRefPubMed
15.
Pauciullo P, Iannuzzi A, Sartorio R, et al. Increased intima-media thickness of the common carotid artery in hypercholesterolemic children. Arterioscler Thromb. 1994;14:1075–9.CrossRefPubMed
16.
Reinher T, Kiess W, de Sousa G, et al. Intima media thickness in childhood obesity: relations to inflammatory marker, glucose metabolism, and blood pressure. Metabolism. 2006;55:113–8.CrossRef
17.
Bonora E, Tessari R, Micciolo R, et al. Intimal-medial thickness of the carotid artery in nondiabetic and NIDDM patients. Relationship with insulin resistance. Diabetes Care. 1997;20:627–31.CrossRefPubMed
18.
Gunczler P, Lanes R, Lopez E, et al. Cardiac mass and function, carotid artery intima-media thickness and lipoprotein (a) levels in children and adolescents with type 1 diabetes mellitus of short duration. J Pediatr Endocrinol Metab. 2002;15:181–6.PubMed
19.
Parikh A, Sochett EB, McCrindle BW, et al. Carotid artery distensibility and cardiac function in adolescents with type 1 diabetes. J Pediatr. 2000;137:465–9.CrossRefPubMed
20.
Järvisalo MJ, Putto-Laurila A, Jartti L, et al. Carotid artery intima-media thickness in children with type 1 diabetes. Diabetes. 2002;51:493–8.CrossRefPubMed
21.
22.
American Academy of Pediatrics. American Academy of Pediatrics. Committee on Nutrition. Cholesterol in childhood. Pediatrics. 1998;101:141–7.
23.
Neuhauser HK, Thamm M, Ellert U, et al. Blood pressure percentiles by age and height from nonoverweight children and adolescents in Germany. Pediatrics. 2011;127:978–88.CrossRef
24.
Kromeyer-Hauschild K, Wabitsch M, Kunze D, et al. Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd. 2001;149:807–18.CrossRef
25.
Roman MJ, Naqvi TZ, Gardin JM, et al. American Society of Echocardiography; Society of Vascular Medicine and Biology. Clinical application of noninvasive vascular ultrasound in cardiovascular risk stratification: a report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology. J Am Soc Echocardiogr. 2006;19:943–54.CrossRefPubMed
26.
Babar GS, Zidan H, Widlansky ME, et al. Impaired endothelial function in preadolescent children with type 1 diabetes. Diabetes Care. 2011;34:681–5.CrossRefPubMedCentralPubMed
27.
Singh TP, Groehn H, Kazmers A. Vascular function and carotid intimal-medial thickness in children with insulin-dependent diabetes mellitus. J Am Coll Cardiol. 2003;41:661–5.CrossRefPubMed
28.
Peppa-Patrikiou M, Scordili M, Antoniou A, et al. Carotid atherosclerosis in adolescents and young adults with IDDM. Relation to urinary endothelin, albumin, free cortisol, and other factors. Diabetes Care. 1998;21:1004–7.CrossRefPubMed
29.
Schwab KO, Doerfer J, Krebs A, et al. Early atherosclerosis in childhood type 1 diabetes: role of raised systolic blood pressure in the absence of dyslipidaemia. Eur J Pediatr. 2007;166:541–8.CrossRefPubMed
30.
Krebs A, Schmidt-Trucksäss A, Doerfer J, et al. Cardiovascular risk in pediatric type 1 diabetes: sex-specific intima-media thickening verified by automatic contour identification and analyzing systems. Pediatr Diabetes. 2012;13:251–8.CrossRefPubMed
31.
Valerio G, Spagnuolo MI, Lombardi F, et al. Physical activity and sports participation in children and adolescents with type 1 diabetes mellitus. Nutr Metab Cardiovasc Dis. 2007;5:376–82.CrossRef
32.
Bryden KS, Neil A, Mayou RA, et al. Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care. 1999;12:1956–60.CrossRef
Metadaten
Titel
Gender, metabolic control and carotid intima-media-thickness in children and adolescents with type 1 diabetes mellitus
verfasst von
Georgiana-Aura Giurgea, MD
Katrin Nagl, MD
Michael Gschwandtner, MD
Clemens Höbaus, MD
Thomas Hörtenhuber, MD
Renate Koppensteiner, MD
Christian Margeta, MD
Maria Fritsch, MD
Birgit Rami-Merhar, MD
Gerit-Holger Schernthaner, MD
Oliver Schlager, MD
Edith Schober, MD
Sabine Steiner, MD
Andrea Willfort-Ehringer, MD
Publikationsdatum
01.02.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 3-4/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0640-3

Weitere Artikel der Ausgabe 3-4/2015

Researcher of the month

  • MUW researcher of the month

Mitteilungen der Gesellschaft

  • mitteilungen der gesellschaft

Detection of necrosis of the gastric fundus after blunt abdominal trauma by PET-CT

  • images in clinical medicine

Novel agents have a significant impact on survival of patients with multiple myeloma

  • original article

The Radio-protective effects of Caffeic Acid Phenethyl Ester and Thymoquinone in rats exposed to total head irradiation

  • original article

A pain in the throat: a 19-year history of symptoms relating to the carotid artery

  • case report