The effect of cardiovascular risk factors on the longitudinal evolution of the carotid intima medial thickness in children with type 1 diabetes mellitus.
The effect of cardiovascular risk factors on the longitudinal evolution of the carotid intima medial thickness in children with type 1 diabetes mellitus.
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DOI：
10.1186/1475-2840-10-53
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发表时间：
2011-06-16
影响因子：
9.3
通讯作者：
Bechtold S
中科院分区：
文献类型：
--
作者：
Dalla Pozza R;Beyerlein A;Thilmany C;Weissenbacher C;Netz H;Schmidt H;Bechtold S
1型糖尿病是公认的动脉粥样硬化危险因素。这项前瞻性纵向研究的目的是用标准化方法评估儿童和青少年1型糖尿病(T1 DM)患者颈动脉内膜-中层厚度(CIMT)的变化。4年后，我们重新评估了最初150例(80%)T1 DM患者中的70例(38%)接受CIMT治疗。重新评估时，平均(±SD)年龄为16.45±2.59岁，平均糖尿病病程为9.2±3.24年，平均糖化血红蛋白为8.14±1.06%。4年间CIMTz评分显著增加(0.001.5 8±0.75，P<0.0 1)，体重指数z评分(0.4 1±0.81，P<0.0 1)、收缩压(0.77±1.15，P<0.0 1)和糖化血红蛋白(0.90±1.0 7，P<0.0 1)显著增加。在线性回归模型中，首次测量时的收缩压z分数(0.02，CI：0.01，0.04)是CIMT z分数平均效应的显著预测因子。在Logistic回归模型中，≥1.5z分值增加的显著危险因素分别是BMIz分值(OR：3.02，CI：1.11，10.14)、糖尿病病程(OR：1.32，CI：1.04，1.77)和第一次测量时的收缩压(OR：1.14，CI：1.04，1.27)。纵向CIMT测量显示，在四年的时间里，糖尿病儿童和青少年亚临床动脉粥样硬化的进展。收缩压和BMI与CIMT增加有关。通过生活方式和药物干预控制这些危险因素可能会阻止糖尿病儿童CIMT的进展。
Type 1 diabetes mellitus is a generally accepted atherogenic risk factor. The aim of this prospective longitudinal study was to evaluate changes in carotid intima media thickness (cIMT) in children and adolescents with type 1 diabetes mellitus (T1DM) using standardized methods. We re-evaluated cIMT in 70 (38 f) of initial 150 (80 f) patients with T1DM after 4 years. At re-evaluation, mean (± SD) age was 16.45 ± 2.59 y, mean diabetes duration was 9.2 ± 3.24 y and patients had a mean HbA1c of 8.14 ± 1.06%. Mean cIMT z-scores increased significantly during 4 years (0.58 ± 0.75, p < 0.001) as well as BMI-z-score (0.41 ± 0.81, p < 0.01), systolic blood pressure (0.77 ± 1.15, p < 0.01) and HbA1c (0.90 ± 1.07, < 0.001). In a linear regression model systolic blood pressure z-score at first measurement (0.02, CI: 0.01, 0.04) was a significant predictor for the mean effect on cIMT z-score. In a logistic regression model significant risk factors for an increase in IMT of ≥1.5 z-scores were BMI z-scores (OR: 3.02, CI:1.11, 10.14), diabetes duration (OR:1.32, CI:1.04, 1.77) and systolic blood pressure (OR: 1.14, CI: 1.04, 1.27) at first measurement each. Longitudinal cIMT measurements revealed progression in subclinical atherosclerosis during a four year period in diabetic children and adolescents. Systolic blood pressure and BMI were related to cIMT increment. Control of these risk factors by lifestyle and medical intervention may prevent progression of cIMT in diabetic children.
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影响因子：
37.8
作者：
Koeijvoets, KCMC;Rodenburg, J;Sijbrands, EJG
通讯作者：
Sijbrands, EJG
影响因子：
4.9
作者：
Jourdan, C;Wühl, E;Schaefer, F
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Schaefer, F
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Meyer, Andreas A.;Kundt, Guether;Kienast, Wolfgang
通讯作者：
Kienast, Wolfgang
影响因子：
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作者：
Wright, Rohana J.;Newby, David E.;Frier, Brian M.
通讯作者：
Frier, Brian M.
影响因子：
9.8
作者：
BURKE, GL;WEBBER, LS;BERENSON, GS
通讯作者：
BERENSON, GS