Microangiopathy of common carotid vasa vasorum in type 1 diabetes mellitus

• Published in: Atherosclerosis Vol. 241; no. 2; pp. 334 - 338
• Main Authors: Rubinat, Esther, Ortega, Emilio, Traveset, Alicia, Arcidiacono, Maria V, Alonso, Nuria, Betriu, Angels, Granado-Casas, Minerva, Hernández, Marta, Soldevila, Jordi, Puig-Domingo, Manel, Jurjo, Carmen, Fernández, Elvira, Mauricio, Didac
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.08.2015
• Subjects: Adult; Atherosclerosis; Cardiovascular; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - etiology; Carotid Artery, Common - diagnostic imaging; Carotid Intima-Media Thickness; Carotid ultrasound; Case-Control Studies; Contrast Media; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetic Angiopathies - diagnostic imaging; Diabetic Angiopathies - etiology; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - etiology; Early Diagnosis; Female; Humans; Macrovascular disease; Male; Middle Aged; Predictive Value of Tests; Type 1 diabetes mellitus; Vasa vasorum; Vasa Vasorum - diagnostic imaging; Vasa vasorum; Diabetic retinopathy; Macrovascular disease; Carotid ultrasound; Atherosclerosis; Type 1 diabetes mellitus
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2015.05.024

Abstract Objective We hypothesize that in type 1 diabetes vasa vasorum (VV) are affected by microangiopathic changes. For this purpose, we assessed the status of the VV signal in patients with type 1 diabetes. Methods The VV signal at the arterial adventitia of the common carotid artery was evaluated by contrast-enhanced ultrasound imaging. The VV contrast agent signal was quantified in an plaque-free arterial segment as the ratio of the adventitial signal and that of the lumen of the artery. We studied 113 type 1 diabetic patients, 60 with and 53 without retinopathy and without known cardiovascular disease, and a group of 78 non-diabetic subjects free of cardiovascular risk factors. All study subjects underwent a clinical evaluation. Results The mean ± standard deviation VV signal of healthy subjects was 0.562 ± 0.135. Type 1 diabetic patients showed a higher adventitial VV signal (0.723 ± 0.128) than non-diabetic subjects (P < 0.0001). After adjustment for cardiovascular risk confounders, this difference remained significant. No differences in VV signal, or common carotid intima-media thickness, between subjects with and without retinopathy were found. Conclusions Type 1 diabetic patients, independently of their retinopathy status, show an increased angiogenesis of the VV of the common carotid artery compared with non-diabetic subjects. Diabetic microangiopathy, that according to our results would also affect the wall of the large arteries, could be a factor contributing to atherosclerosis in type 1 diabetes mellitus.