Preclinical arterial disease in patients with type 1 diabetes without other major cardiovascular risk factors or micro-/ macrovascular disease

Abstract

We aimed to investigate preclinical atherosclerosis in T1D and its relationship with glucose profile and endothelial/ inflammatory markers. Thirty-eight T1D patients without additional cardiovascular risk factors or micro-/macrovascular complications and 22 healthy matched subjects were included. FMD and cIMT/fIMT were performed in addition to 72-h continuous glucose monitoring and the measurement of endothelial/inflammatory markers. Lower FMD percentages and greater cIMT/fIMT were observed in patients with T1D in comparison with controls (FMD 7.0±3.1% vs. 9.6±2.2%; p<0.005; cIMT 0.523±0.091 mm vs. 0.471±0.061 mm; p<0.05 and fIMT 0.512±0.172mm vs. 0.394±0.061mm; p<0.01, for patients and controls, respectively). T1D subjects in the highest tertile of cIMT were older than those in the lowest group (39.9±9.5 vs. 29.6±4.7 years; p<0.005) and had a longer duration of the disease (18.7±5.4 years vs. 11.8±6.4 years). The higher the cIMT tertile, the greater the fIMT (0.397±0.114 mm vs. 0.431±0.082 mm vs. 0.583±0.197 mm; p<0.05). MAGE was negatively correlated to FMD ( r=-0.328; p<0.05) and positively to cIMT ( r=0.322; p<0.05). There were no differences between cIMT tertiles in terms of metabolic parameters or endothelial and inflammatory markers. Signals of preclinical atherosclerosis in T1D even in the absence of cardiovascular risk factors and micro- / macrovascular disease are reported. Our findings suggest that daily glucose instability could negatively impact vascular function and structure.