Evolution and predictors of morphological and functional arterial changes in the course of type 1 diabetes mellitus

Diabetes Metab Res Rev. 2010 Nov;26(8):646-55. doi: 10.1002/dmrr.1133. Epub 2010 Oct 4.

Abstract

Background: Diabetes mellitus results in accelerated atherosclerosis. We evaluated preclinical, morphological and functional vascular changes in type 1 diabetes mellitus.

Methods: Diameter, intima-media thickness, intima-media cross-section area, and elasticity features (compliance, distensibility coefficient, circumferential strain, stiffness index, incremental elastic modulus) of the common carotid arteries and carotid-femoral pulse wave velocity were studied in 42 patients with type 1 diabetes mellitus without macroangiopathy, and 41 control subjects matched for sex, age and body mass index using an ultrasonographic vessel wall-movement tracking system and applanation tonometry.

Results: Significantly larger intima-media thickness (523 ± 55 versus 567 ± 89 µm, p < 0.01), intima-media cross-section area (11.60 ± 1.81 versus 13.08 ± 3.02 mm(2) , p < 0.01), SI (5.58 ± 1.24 versus 7.08 ± 2.69, p < 0.01) and pulse wave velocity (6.00 ± 0.82 versus 6.61 ± 1.56 m/s, p < 0.05) were found in type 1 diabetes mellitus patients compared to controls. When type 1 diabetes mellitus patients with short and long disease duration (≤ or > 10 years) were compared, diameter (6450 ± 433 versus 6847 ± 750 µm, p < 0.05), intima-media cross-section area (11.97 ± 1.98 versus 14.01 ± 3.43 mm, p < 0.05) and pulse wave velocity (5.90 ± 0.92 versus 7.20 ± 1.74 m/s, p < 0.01) differed significantly. When multivariate analyses were restricted to type 1 diabetes mellitus patients, age was an independent predictor of stiffness index and pulse wave velocity, the duration of diabetes mellitus of intima-media cross-section area and pulse wave velocity, systolic blood pressure of diameter and pulse wave velocity, and low-density lipoprotein-cholesterol of intima-media thickness, intima-media cross-section area and stiffness index.

Conclusions: There are differences in the time course of evolution and in predictors of morphological and functional changes in arteries in type 1 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arteries / pathology*
  • Blood Flow Velocity
  • Blood Pressure
  • Carotid Artery, Common / diagnostic imaging
  • Carotid Artery, Common / physiopathology*
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Female
  • Humans
  • Male
  • Pulsatile Flow / physiology
  • Tunica Intima / pathology
  • Tunica Media / pathology
  • Ultrasonography
  • Vascular Resistance