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Submitted on December 26, 2006
Accepted on March 12, 2007
Department of Pediatric Cardiology and Division of Endocrinology and Diabetology, University Children's Hospital, Ludwig-Maximilians-University, Munich, Germany
* To whom correspondence should be addressed. E-mail: Robert.DallaPozza{at}med.uni-muenchen.de.
Context: Cardiovascular disease due to atherosclerosis is a major cause of morbidity and mortality in adult diabetic patients. In children, signs of subclinical atherosclerosis such as increased intima-media-thickness of the common carotid arteries (IMT) have been detected in several studies. Concerns may arise, however, about the different analyzing methods used as measurements in patients and controls differ significantly.
Patients and Methods: We studied 208 children (150 patients with diabetes mellitus type 1, mean age (SD) 13.9 ± 2.8 y, 66 male, mean HbA1c (SD) 7.8 ± 1.4% and 58 healthy controls, mean age (SD) 14.1 ± 3.1 y, 32 male) and used normal IMT-values published recently for comparison of the results.
Results: 37/150 patients had an increased IMT (mean IMT-SD 1.6 ± 0.6) whereas healthy controls had nearly normal IMT-values (mean IMT-SD 0.3 ± 0.1, p < 0.001). Age at onset of diabetes, mean daily insulin dosage, systolic blood pressure and total cholesterol level were significantly related to IMT in a multilinear regression model. 25 diabetic patients were hypertensive and had a significantly increased IMT (mean IMT: 0.475 ± 0.03 mm) compared to the remaining patients (mean IMT: 0.459 ± 0.02 mm, p < 0.05).
Conclusions: The IMT measurement detected subclinical atherosclerosis in a large cohort of diabetic children. Systolic blood pressure, total cholesterol level, insulin dosage and age at onset of the disease were significantly related to the IMT. Longitudinal measurements may help to identify patients at special risk for atherosclerotic changes and cardiovascular disease.
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