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

Abstract

Aim: To evaluate carotid intima-media thickness (IMT) in patients with long-term early-onset type 1 diabetes, and investigate the associations between IMT, diabetic retinopathy and clinical char-acteristics.
Methods: We evaluated anthropometric measurements, biochemical parameters and carotid IMT. Ultrasonography was performed on 73 patients diagnosed with type 1 diabetes before 30 years of age, and who have been living with diabetes for 20 years or more.Results: The mean max-IMT (maximal thickness of whole carotid artery) and IMT-Cmax (maximal thickness of common carotid artery) values were 0.94 mm and 0.67 mm; 21 patients had prolifera-tive diabetic retinopathy and 21 patients had plaque (IMT≥1.1 mm). Age, age at diagnosis of diabe-tes and adolescent HbA_1C level (HbA_1C at 18 years old or the earliest measurement available) were higher in patients with plaque than in those without. Max-IMT was greater in patients with prolifer-ative retinopathy than in those without. Similarly, there were significant differences in current HbA_1C level, and the prevalence of hypertension and dyslipidemia. In multivariate analysis, age and dyslipid-emia were independently associated with max-IMT and IMT-Cmax.Conclusions: Age and dyslipidemia were associated with IMT. In contrast, glycemic control was closely associated with diabetic retinopathy, but weakly associated with IMT.