Document Type : original article
Authors
- Asieh Mosallanejad 1
- Masoomeh Raoufi 2
- marjan Shakiba 3
- Hedieh Saneifard 4
- Mohammadeza Alaee 5
- Dina Rajabifar 6
1 Imam Hossein Medical Center, Shahid Beheshti University of Medical science, Tehran, Iran.
2 Assistant Professor of Radiology Department of Radiology, School of Medicine Imam Hossein Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 department of pediatric endocrinology and metabolism, Mofid children hospital, Shahid Beheshti university of medical science
4 Assistant Professor of Pediatric Endocrinology, Shahid Beheshti University of Medical Sciences, Tehran- Iran
5 Pediatric Endocrinologist Associate Professor, Shahid beheshti University of Medical Sciences
6 school of medicine, shahid beheshti university of medical sciences, Tehran , Iran
Abstract
Background: internal carotid intima thickness has been identified as a predictor of atherosclerosis. Patients with type 1 diabetes are at risk for macrovascular complications. Atherosclerosis is 2 to 4 times more common in patients with diabetes, which exposes them to mortality and morbidity. The aim of this study was to determine the thickness of internal carotid intima thickness in children and adolescents with type 1 diabetes and its relationship with cardiovascular risk factors in Iranian children and adolescents with type 1 diabetes.
Method: The present study is a cross-sectional study that was performed in Mofid and Imam Hossein hospitals in Tehran from 2020 to 2021. A total of 91 patients with type 1 diabetes in the age range of 6-18 years, who have been diagnosed with diabetes for at least three years, were included in the study as a diabetic group.
Result: In total, 91 children and adolescents with type 1 diabetes were included in this study, of which 44 (48.4%) were boys and 47 (51.6%) were girls. The mean age of patients was 12.24 ± 3.17 and ranged from 6 to 18 years. The mean age of the patients at the time of diagnosis was 5.86 ± 2.98. In this study, blood pressure of 6 patients (6.6%) was abnormal and the rest had normal blood pressure. In addition, the mean duration of disease in this study was 6.3 ± 2.57 years. The insulin of most patients (93.2%) was Analogue and only 8.8% of patients used Neutral Protamine Hagedorn (NPH) and Regular. The thickness of the intima of the right internal carotid artery is 0.54 ± 0.05 and the thickness of the intima of the left internal carotid artery is 0.48 ± 0.07.
Conclusion: According to the results of this study, none of the factors of disease duration, age of onset, blood pressure, cholesterol, triglycerides, LDL (Low-Density Lipoprotein), HDL (High-Density Lipoprotein), HbA1C (Hemoglobin A1c), history of CHD (Coronary Heart Disease) and hyperlipidemia were significantly associated with the thickness of the intima of internal carotid artery. However, body mass index showed a significant relationship with the thickness of the left internal carotid intima.
Keywords
- Sun YP, Cai YY, Li HM, Deng SM, Leng RX, Pan HF. Increased carotid intima–media thickness (CIMT) levels in patients with type 1 diabetes mellitus (T1DM): a meta-analysis. Journal of Diabetes and its Complications. 2015 Jul 1; 29(5):724-30.
- Cobble M, Bale B. Carotid intima-media thickness: knowledge and application to everyday practice. Postgraduate medicine. 2010 Jan 1; 122(1):10-8.
- Kavey RE, Allada V, Daniels SR, Hayman LL, McCrindle BW, Newburger JW, Parekh RS, Steinberger J. Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association expert panel on population and prevention science; the councils on cardiovascular disease in the young, epidemiology and prevention, nutrition, physical activity and metabolism, high blood pressure research, cardiovascular nursing, and the kidney in heart disease; and the interdisciplinary working group on quality of care and outcomes research: endorsed by the American Academy of .... Circulation. 2006 Dec 12; 114(24):2710-38.
- Meyer AA, Kundt G, Lenschow U, Schuff-Werner P, Kienast W. Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program. Journal of the American College of Cardiology. 2006 Nov 7; 48(9):1865-70.
- Polak JF, Backlund JY, Cleary PA, Harrington AP, O’Leary DH, Lachin JM, Nathan DM, DCCT/EDIC Research Group. Progression of carotid artery intima-media thickness during 12 years in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. Diabetes. 2011 Feb 1; 60(2):607-13.
- Fusaro MF, Zanini JL, Silva IN. Increased carotid intima-media thickness in Brazilian adolescents with type 1 diabetes mellitus. Diabetology & metabolic syndrome. 2016 Dec; 8(1):1-8.
- El Samahy MH, Matter RM, Youssef OI, El MA, Kamal NA. Relation between carotid intima media thickness and oxidative stress markers in type 1 diabetic children and adolescents. Journal of Diabetes & Metabolic Disorders. 2013 Dec; 12(1):1-7.
- Park MH, Skow Á, De Matteis S, Kessel AS, Saxena S, Viner RM, Kinra S. Adiposity and carotid-intima media thickness in children and adolescents: a systematic review. BMC pediatrics. 2015 Dec; 15(1):1-0.
- Gul K, Ustun I, Aydin Y, Berker D, Erol K, Unal M, Barazi AO, Delibasi T, Guler S. Carotid intima-media thickness and its relations with the complications in patients with type 1 diabetes mellitus. Anadolu Kardiyol Derg. 2010 Feb 1; 10(1):52-8.
- Dalla Pozza R, Bechtold S, Bonfig W, Putzker S, Kozlik-Feldmann R, Netz H, Schwarz HP. Age of onset of type 1 diabetes in children and carotid intima medial thickness. The journal of clinical endocrinology & metabolism. 2007 Jun 1; 92(6):2053-7.
- Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. Bmj. 2012 Sep 25; 345.
- Böhm B, Hartmann K, Buck M, Oberhoffer R. Sex differences of carotid intima-media thickness in healthy children and adolescents. Atherosclerosis. 2009 Oct 1; 206(2):458-63.
- Jourdan C, Wühl E, Litwin M, Fahr K, Trelewicz J, Jobs K, Schenk JP, Grenda R, Mehls O, Tröger J, Schaefer F. Normative values for intima–media thickness and distensibility of large arteries in healthy adolescents. Journal of hypertension. 2005 Sep 1; 23(9):1707-15.
- Mittelman SD, Gilsanz P, Mo AO, Wood J, Dorey F, Gilsanz V. Adiposity predicts carotid intima-media thickness in healthy children and adolescents. The Journal of pediatrics. 2010 Apr 1; 156(4):592-7.
- Rodriguez RR, Gómez-Díaz RA, Haj JT, Garnica FJ, Soriano ER, Meguro EN, Aguilar-Salinas CA, Wacher NH. Carotid intima-media thickness in pediatric type 1 diabetic patients. Diabetes Care. 2007 Oct 1; 30(10):2599-602.
- Lamotte C, Iliescu C, Libersa C, Gottrand F. Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. European journal of pediatrics. 2011 Jun; 170(6):719-29.
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