2Department of Endocrinology, GATA Haydarpaşa Military Hospital, Kadıköy/İstanbul
3Ankara Numune Research and Training Hospital, Endocrinology and Metabolism Clinic, Ankara, Turkey
4Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
5Department of Endocrinology, Afyon State Hospital, Afyon, Turkey
6Department of Biochemistry, Ankara Numune Education and Research Hospital, Ankara, Turkey
Abstract
Objective: Atherosclerosis is the major cause of the morbidity and mortality in type 1 diabetes mellitus (DM). Carotid intima-media thickness (CIMT) is the early sign of atherosclerosis and thereby, also the sign of macrovascular diseases. In this study, we aimed to evaluate the CIMT in patients with type 1 DM, and its association with diabetic microvascular complications (nephropathy-retinopathy). Materials and Methods: One hundred and thirteen consecutive patients with type 1 DM without macrovascular disease were enrolled into this cross-sectional study. Age, gender, and body mass index matched 59 healthy subjects, were taken as the control group. Microvascular complications in diabetic patients were scanned. Ultrasonographic analysis of the carotid artery was performed with a high-resolution ultrasound scanner. Student’s t, Mann Whitney U, Chi-square and Kruskal-Wallis tests, as well as multiple linear regression analysis were used for the statistical analysis. Results: Patients with type 1 DM had significantly higher CIMT compared to control group (p<0001). The CIMT of the patients with microvascular complications (nephropathy and/or retinopathy) was significantly increased (0.70±0.11 mm) compared with the patients without complications (0.63 ± 0.09 mm) (p=0.001). The increase in CIMT in type 1 DM in multiple regression analysis was dependent on the presence of proliferative retinopathy (beta=0.037, 95%CI 0.010-0.065, p=0.008), macroalbuminuria (beta=0.043, 95%CI 0.019-0.068, p=0.001), increased urinary albumin excretion (beta=0.00003, 95%CI 0.00001-0.00005, p=0.005) and duration of diabetes (beta=0.002, 95%CI 0.001-0.003, p=0.009). Conclusions: Increment of CIMT in type 1 diabetic patients was associated with microvascular complications, suggesting that diabetic microangiopathy is related with macroangiopathy. Therefore, there is a need for prospective studies to show the effect of increased CIMT on prognosis of type 1 DM.