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 characteristics. 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 proliferative diabetic retinopathy and 21 patients had plaque (IMT > or =1.1 mm). Age, age at diagnosis of diabetes 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 proliferative 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 dyslipidemia 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.