International Society for Pediatric and Adolescent Diabetes
ISPAD 2014 | 40th Anniversary |
245
P157
Abdominal obesity evaluated by waist-to-height-ratio as an independent predictor of carotid
intima media thickness (IMT) in young patients with type 1 diabetes mellitus (T1D)
K. Nagl
1
, E. Duffles
2
, G. Gericke
2
, S. Sabeti-Sandor
2
, C. Höbaus
2
, M. Fritsch
1
, T. Hoertenhuber
1
, G.-H.
Schernthaner
2
, B. Rami-Merhar
1
1
Medical University Vienna, Department of Pediatrics and Adolescent Medicine, Vienna, Austria,
2
Medical University Vienna, Internal Medicine II, Department of Angiology, Vienna, Austria
Objectives:
Starting from young age T1D-patients have a high risk of developing cardiovascular
diseases (CVD) early in their lives. Carotid IMT, a marker for atherosclerosis was often found elevated
in young T1D-patients. However, the association of IMT and glycemic control in young T1D-patients
has been inconsistent. We wanted to evaluate the relation and role of IMT and other CVD risk factors.
Methods:
We measured mean and maximum IMT (IMTm) in 77 young adults and adolescents with
T1D (age: 19±3 years, diabetes duration (DD): 11±3 years, HbA1c 7.8±1.4 %) and in 25 controls
(age:23±2 years) via ultrasound. We examined CVD risk factors i.e. serum lipids, body-mass-index
(BMI), waist circumference (WC), waist-to-height-ratio (WHTR), blood pressure, interleukin-6 (IL6) and
high-sensitive c-reactive protein (hsCRP).
Results:
T1D-patients had higher systolic blood pressure (SBP) than controls (t=2.669, p=0.009) and
larger WC (t: -2.485, p=0.015). There was no significant (sign.) difference in BMI, serum lipids, hsCRP
or IL-6. Age-adjusted IMT did not differ sign. between groups. In controls IMT was only SBP-related
(r=0.482, p=0.017). In diabetics there was no correlation of IMT with HbA1c, SBP, BMI, IL-6 or hsCRP,
but IMTm was related to WC (r=0.281, p=0.017) and WHTR (r=0.258, p=0.033). Adjusting for age,
sex, Hba1c, DD, SBP, smoking and lipids, WHTR remained the only significant independent predictor
of IMTm (beta=0.329, p=0.024). T1D-patients with increased WHTR (>0.5) (19%) had higher levels of
hsCRP (t=-3.316, p=0.013) but they did not differ sign. in HbA1c-levels.
Conclusions:
We found no significant difference in IMT between controls and young adults with T1D.
Every 5th young T1D-patient had an increased WHTR. The association of WHTR with higher IMT
independent of other CVD risk factors suggests the importance of measuring WHTR in young T1D-
patients. Independent of glycemic control, young diabetics with abdominal obesity could be the group
most at risk for CVD.
