Carotid Atherosclerosis in Adolescents and Young Adults With IDDM: Relation to urinary endothelin, albumin, free cortisol, and other factors
- Melpomeni Peppa-Patrikiou, MD,
- Maria Scordili, MD,
- Aristidis Antoniou, MD,
- Maria Giannaki, MD,
- Maria Dracopoulou, MD and
- Catherine Dacou-Voutetakis, MD
- Diabetes Center and Endocrine Unit, Athens University Medical School Athens, Greece
- First Pediatric Department; the Radiology Department, Athens University Medical School Athens, Greece
- “Aghia Sophia” Children's Hospital, Athens University Medical School Athens, Greece
- Address correspondence and reprint requests to Catherine Dacou-Voutetakis, Associate Professor, First Pediatric Department, Athens University, “Aghia Sophia” Children's Hospital, Goudi, Athens 11527, Greece.
Abstract
OBJECTIVE To investigate 1) alterations of carotid intimal-plus-medial thickness (IMT) in subjects with IDDM and 2) the relation of IMT to indexes of diabetic angiopathy and to risk factors of atherosclerosis.
RESEARCH DESIGN AND METHODS IMT was assessed by ultrasound B-mode imaging in 39 subjects with IDDM (23 male, 16 female young adults aged 17.5 ± 5.2 years, diabetes duration 8.8 ± 5.9) and in 22 control subjects (healthy siblings of the IDDM subjects) of comparable age. Urinary endothelin (UET1) and urinary free cortisol (UFC) were determined by radioammunoassay (RIA), urinary albumin by nephelometry, HbA1c by high-performance liquid chromatography (HPLC), and plasma renin by immunoradiometric assay (IRMA).
RESULTS The IMT values were greater in IDDM subjects than in control subjects (0.49 ± 0.1 mm, 0.44 ± 0.09 mm, respectively; P = 0.048) and greater in IDDM male subjects than in control male subjects (0.52 ± 0.09 and 0.44 ± 0.06 mm, respectively; P = 0.015), with no difference between IDDM and control female subjects. The IMT values were greater in diabetic male subjects than in female subjects (0.52 ± 0.09 and 0.45 ± 0.1 mm, respectively; P = 0.017). In IDDM subjects, but not in control subjects, there was a positive correlation of IMT to urinary albumin (P = 0.008), systolic blood pressure (P = 0.023), UET1 (P = 0.016), UFC (P = 0.002), and BMI (P = 0.021). Multiple regression analysis demonstrated that in IDDM subjects the variable that interacts independently with IMT was the BMI (P = 0.001).
CONCLUSIONS IMT, an index of atherosclerosis (macroangiopathy), is increased in IDDM subjects quite early (already in adolescence), and it is positively related to urinary albumin, UET1, blood pressure, and UFC.
- Received August 21, 1997.
- Accepted February 16, 1998.
- Copyright © 1998 by the American Diabetes Association
