Family histories of Type II diabetes and hypertension predict intima-media thickness in patients with Type I diabetes

• Published in: Diabetologia 2002-05, Vol.45 (5), p.711-718
• Main Authors: MÄKIMATTILA, S, YLITALO, K, SCHLENZKA, A, TASKINEN, M.-R, SUMMANEN, P, SYVÄNNE, M, YKI-JÄRVINEN, H
• Format: Article
• Language: English
• Subjects: Adult; Albuminuria; Associated diseases and complications; Biological and medical sciences; Blood Glucose - metabolism; Blood Pressure; Body Mass Index; Carotid Arteries - diagnostic imaging; Child; Diabetes Mellitus, Type 1 - genetics; Diabetes Mellitus, Type 1 - pathology; Diabetes Mellitus, Type 2 - genetics; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - genetics; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Follow-Up Studies; Humans; Hypertension - genetics; Lipids - blood; Medical sciences; Predictive Value of Tests; Retrospective Studies; Risk Factors; Smoking; Tunica Intima - pathology; Tunica Media - pathology; Ultrasonography
• ISSN: 0012-186X; 1432-0428
• DOI: 10.1007/s00125-002-0817-6

Hyperglycaemia predicts microvascular complications but data on macrovascular disease are limited. We searched for predictors of carotid artery intima-media thickness in young adults with Type I (insulin-dependent) diabetes mellitus. A total of 71 children (F/M = 34/37) were followed after their diagnosis until they reached 32 +/- 1 years of age, when duration of diabetes averaged 22 +/- 1 years. Cardiovascular risk markers [lipids, blood pressure, smoking, urinary albumin excretion rate, lifetime glycaemic exposure (A(1c) months), exercise habits, alcohol consumption, family history] were evaluated at age 21 +/- 1 for the baseline examination and at age 32 +/- 1 years for the follow-up examination years. During follow-up, intima-media thickness of common and internal carotid arteries and the carotid bulb were quantitated using a high-resolution B-mode ultrasound. In univariate analysis, age, BMI, blood pressure, lifetime glycaemic exposure, a positive family history of Type II (non-insulin-dependent) diabetes mellitus, hypertension and cardiovascular disease were predictors of carotid intima-media thickness. In multivariate analysis, a positive family history of Type II diabetes predicted maximal ( p< 0.05) and common ( p< 0.005) carotid artery intima-media thickness, family history of hypertension predicted increases in maximal ( p< 0.04), and far wall ( p< 0.006) carotid artery intima-media thickness, and lifetime glycaemic exposure was an independent predictor of increased carotid bulb thickness ( p< 0.03). Positive family histories of Type II diabetes and hypertension are independent predictors of carotid intima-media thickness in patients with Type I diabetes, and could therefore predispose these patients to atherosclerosis