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Type: Journal article
Title: Early atherosclerosis relates to urinary albumin excretion and cardiovascular risk factors in adolescents with type 1 diabetes: adolescent type 1 Diabetes cardiorenal Intervention Trial (AdDIT)
Author: Maftei, O.
Pena, A.
Sullivan, T.
Jones, T.
Donaghue, K.
Cameron, F.
Davis, E.
Cotterill, A.
Craig, M.
Gent, R.
Dalton, N.
Daneman, D.
Dunger, D.
Deanfield, J.
Couper, J.
Citation: Diabetes Care, 2014; 37(11):3069-3075
Publisher: American Diabetes Association
Issue Date: 2014
ISSN: 0149-5992
Statement of
Oana Maftei, Alexia S. Pena, Thomas Sullivan, Timothy W. Jones, Kim C. Donaghue, Fergus J. Cameron, Elizabeth Davis, Andrew Cotterill, Maria E. Craig, Roger Gent, Neil Dalton, Denis Daneman, David Dunger, John Deanfield, and Jenny J. Couper, on behalf of the AdDIT Study Group
Abstract: OBJECTIVE: The origins of cardiovascular and renal disease in type 1 diabetes begin during childhood. We aimed to evaluate carotid (cIMT) and aortic intima-media thickness (aIMT) and their relationship with cardiovascular risk factors and urinary albumin excretion in adolescents with type 1 diabetes in the Adolescent Type 1 Diabetes cardio-renal Intervention Trial (AdDIT). RESEARCH DESIGN AND METHODS: A total of 406 adolescents with type 1 diabetes, who were 14.1 ± 1.9 years old with type 1 diabetes duration of 6.7 ± 3.7 years, and 57 age-matched control subjects provided clinical and biochemical data and ultrasound measurements of vascular structure (cIMT and aIMT). Vascular endothelial and smooth muscle function was also measured in 123 of 406 with type 1 diabetes and all control subjects. RESULTS: In type 1 diabetic subjects, mean/maximal aIMT (P < 0.006; <0.008), but not mean/maximal cIMT, was greater than in control subjects. Mean/maximal aIMT related to urinary albumin-to-creatinine ratio (multiple regression coefficient [SE], 0.013 [0.006], P = 0.03; 0.023 [0.007], P = 0.002), LDL cholesterol (0.019 [0.008], P = 0.02; 0.025 [0.011], P = 0.02), and age (0.010 [0.004], P = 0.004; 0.012 [0.005], P = 0.01), independent of other variables. Mean/maximal cIMT was greater in males (0.023 [0.006], P = 0.02; 0.029 [0.007], P < 0.0001), and mean cIMT related independently to systolic blood pressure (0.001 [0.001], P = 0.04). Vascular smooth muscle function related to aIMT and cIMT but not to urinary albumin excretion. CONCLUSIONS: aIMT may be a more sensitive marker of atherosclerosis than cIMT in type 1 diabetes during mid-adolescence. Higher urinary albumin excretion, even within the normal range, is associated with early atherosclerosis and should direct clinical attention to modifiable cardiovascular risk factors.
Keywords: AdDIT Study Group; Endothelium, Vascular; Albuminuria; Cardiovascular Diseases; Diabetes Mellitus, Type 1
Rights: © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
RMID: 0030016822
DOI: 10.2337/dc14-0700
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