Carotid artery intima-media thickness in children with type 1 diabetes
Carotid artery intima-media thickness in children with type 1 diabetes
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DOI：
10.2337/diabetes.51.2.493
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发表时间：
2002-02-01
期刊：
影响因子：
7.7
通讯作者：
Raitakari, OT
中科院分区：
文献类型：
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作者：
Järvisalo, MJ;Putto-Laurila, A;Raitakari, OT
尸检研究表明，青少年的糖尿病状态与动脉粥样硬化病变之间存在关系。本研究的目的是阻止I型糖尿病儿童亚临床动脉粥样硬化(测量为颈动脉内中膜厚度[IMT])及其危险因素(包括脂蛋白氧化)的存在。我们使用高分辨率超声测量了85名儿童(平均年龄11+/-2岁)的颈动脉IMT：50名I型糖尿病患者(平均病程4.4+/-3.0年)和35名年龄、性别和体型匹配的健康对照组受试者。通过测定42名儿童(21名糖尿病患者和21名对照组)Cu2+诱导的共轭双烯的形成来确定低密度脂蛋白对氧化的敏感性。糖尿病组平均颈动脉内膜中层厚度增加(0.47±0.04vs.0.42±0.04 mm；P<；0.0001)。两组之间的总胆固醇和低密度脂蛋白浓度相似，但糖尿病儿童的低密度脂蛋白二烯形成率增加(0.49+/-0.06vs.0.45+/-0.07mumol/niin；P<；0.05)，这表明体外低密度脂蛋白的氧化性增加。在针对所有受试者的多变量模型中，与颈动脉内膜厚度相关的独立因素是糖尿病状态(P<；0.001)、低密度脂蛋白胆固醇水平(P<；0.001)和收缩压(P<；0.001)。在糖尿病儿童中，低密度脂蛋白氧化能力与平均IMT显著相关(r=0.47，P<；0.05)，在控制低密度脂蛋白胆固醇水平后，这种关系仍然显著。我们得出结论，1型糖尿病是儿童颈动脉IMT增加的独立危险因素。这些数据还表明，低密度脂蛋白氧化修饰增加可能与糖尿病儿童早期结构性动脉粥样硬化血管改变有关。
Postmortem studies have shown a relationship between diabetic state and atherosclerotic arterial lesions in adolescents. The aim of the present study was to deter mine the presence of increased subclinical atherosclerosis (measured as carotid intima-media thickness [IMT]) and its risk factors, including lipoprotein oxidation, in children with type I diabetes. We measured carotid IMT using high-resolution ultrasound in 85 children (mean age, 11 +/- 2 years): 50 with type I diabetes (mean duration, 4.4 +/- 3.0 years) and 35 healthy control subjects matched for age, sex, and body size. The susceptibility of LDL to oxidation was determined by measuring the formation of conjugated dienes induced by Cu2+ in 42 children (21 with diabetes and 21 control subjects). The mean carotid IMT was increased in children with diabetes (0.47 +/- 0.04 vs. 0.42 +/- 0.04 mm.; P < 0.0001). Total cholesterol and LDL cholesterol concentrations were similar between the groups, but the children with diabetes had increased LDL diene formation rate (0.49 +/- 0.06 vs. 0.45 +/- 0.07 mumol/niin; P < 0.05), suggesting increased in vitro LDL oxidizability. In a multivariate model for all subjects, the independent correlates for IMT were the diabetic state (P < 0.001), LDL cholesterol level (P < 0.001), and systolic blood pressure (P < 0.001). In children with diabetes but not in control subjects, LDL oxidizability correlated significantly with mean IMT (r = 0.47, P < 0.05), and this relationship remained significant after controlling for LDL cholesterol level. We conclude that type 1 diabetes is an independent risk factor for increased carotid IMT in children. These data also suggest that increased oxidative modification of LDL may be related to early structural atherosclerotic vascular changes in children with diabetes.