Early onset of subclinical atherosclerosis in young persons with type 1 diabetes

Abstract

Objective: To evaluate the degree of atherosclerosis and its risk factors in adolescents and young adults with type 1 diabetes.

Study design: We measured carotid artery intima-media thickness (IMT) in 142 subjects with type 1 diabetes (mean [SD] age = 16.0 [2.6] years) and 87 control subjects (18.8 [3.1] years). Fasting lipid and homocysteine levels, degree of glycemic control, blood pressure, and body mass index were measured in persons with diabetes.

Results: The mean carotid IMT was greater in persons with diabetes ( P = .002). Among subjects with type 1 diabetes, lipid levels were significantly higher in female subjects compared with male subjects. The mean carotid IMT was significantly higher in persons with a diabetic complication (including hypertension, retinopathy, or microalbuminuria). In male subjects but not female subjects, HDL cholesterol and the LDL/HDL ratio were correlated with carotid IMT.

Conclusions: Adolescents with type 1 diabetes have increased atherosclerosis compared with control subjects. Risk factors for increased carotid IMT in these younger patients include diabetic complications and HDL cholesterol and the LDL/HDL ratio, which may be sex-specific.