Subclinical atherosclerosis in diabetic children: results of a longitudinal study

• Published in: Pediatric diabetes Vol. 11; no. 2; pp. 129 - 133
• Main Authors: Pozza, Robert Dalla, Netz, Heinrich, Schwarz, Hans-Peter, Bechtold, Susanne
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2010
• Subjects: Adolescent; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - pathology; carotid ultrasound; Child; Diabetes Mellitus, Type 1 - epidemiology; Diabetic Angiopathies - epidemiology; Disease Progression; Female; Humans; IMT; Longitudinal Studies; Male; preventive medicine; subclinical atherosclerosis; Tunica Intima - pathology; Tunica Media - pathology; Ultrasonography
• ISSN: 1399-543X; 1399-5448
• DOI: 10.1111/j.1399-5448.2009.00540.x

Dalla Pozza R, Netz H, Schwarz HP, Bechtold S. Subclinical atherosclerosis in diabetic children: results of a longitudinal study. Context: Cardiovascular disease caused by atherosclerosis is a major cause of morbidity and mortality in adult diabetic patients. In children, we detected signs of subclinical atherosclerosis in a large patient cohort. This study reports the results of a longitudinal observation in this patient group. Patients and methods: Of the 37/150 diabetic children in whom an increased intima‐media thickness (IMT) of the carotid artery had been found, 27 (mean age 14.6 ± 2.6 yrs) could be reevaluated 2 yrs after the initial study. Of the 27, 5 patients were on medication with angiotensin‐converting enzyme (ACE) inhibitors, and all patients underwent detailed counselling of their lifestyle, sports activity, and nutritional habits. Results: Mean IMT increased significantly (0.49 ± 0.02 mm vs. 0.51 ± 0.026 mm, p < 0.05) However, there was no significant change compared to normal values (mean IMT z‐score 2.4 ± 0.3 vs. 2.6 ± 0.5). Of the 27, 13 patients (48%) showed a progression of the IMT whereas in 14/27 patients the IMT values remained stable. In these subgroups, patients with IMT progression showed a higher hemoglobin A1c (HbA1c) (7.5 ± 0.8 vs. 7.1 ± 0.7, p < 0.05) and a slightly higher systolic blood pressure (120 ± 14.4 vs. 113.9 ± 12.1, p = 0.08). Conclusions: In a well‐selected group of diabetic children, mean IMT progression during a 2‐yr period did not exceed the physiological increase. Children with a higher HbA1c and a higher systolic blood pressure showed a progression of the IMT. Control of atherogenic risk factors in diabetic children may help to avoid subclinical atherosclerosis progression.