Possible early detection of coronary artery calcium progression in type 1 diabetes: A case-control study of normoalbuminuric type 1 diabetes patients and matched controls

TY - JOUR

T1 - Possible early detection of coronary artery calcium progression in type 1 diabetes

T2 - A case-control study of normoalbuminuric type 1 diabetes patients and matched controls

AU - Hjortkjær, Henrik Ø

AU - Jensen, Tonny

AU - Hilsted, Jannik

AU - Corinth, Helle

AU - Mogensen, Ulrik M

AU - Køber, Lars

AU - Fuchs, Andreas

AU - Nordestgaard, Børge G

AU - Kofoed, Klaus F

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/7

Y1 - 2018/7

N2 - AIMS: Coronary artery calcium (CAC) is associated with cardiovascular (CV) disease and progression of CAC is an independent predictor of mortality. Type 1 diabetes is associated with increased CV risk, especially in persons with cardiovascular autonomic neuropathy (CAN). This study aimed to examine whether short-term progression of CAC is increased in persons with type 1 diabetes compared to matched controls and if CAN increases risk of CAC progression.METHODS: Fifty-three normoalbuminuric persons with long-term type 1 diabetes (20 with CAN) were matched in a 1:2 ratio with 106 controls without diabetes according to age, sex and baseline CAC. All were examined twice with cardiac computed tomography scans. Progression of CAC was defined as a value ≥2.5 between the square root-transformed values of follow-up and baseline CAC volume scores.RESULTS: The participants were examined median (interquartile range) of 25 (23-27) months (type 1 diabetes) and 29 (25-33) months (controls) apart. In multivariable logistic regression, participants with type 1 diabetes had an odds ratio of 3.3 (95% CI 1.3-8.2, p = 0.01) for CAC progression. CAN did not increase progression of CAC (p = 0.64).CONCLUSIONS: Progression of CAC was increased in well-treated, normoalbuminuric persons with type 1 diabetes compared to matched controls without diabetes, suggesting that type 1 diabetes is a risk factor for short-term progression. This finding could explain some of the increased morbidity and mortality observed in persons with type 1 diabetes, but it does not specifically explain the increased CV risk in persons with CAN.

AB - AIMS: Coronary artery calcium (CAC) is associated with cardiovascular (CV) disease and progression of CAC is an independent predictor of mortality. Type 1 diabetes is associated with increased CV risk, especially in persons with cardiovascular autonomic neuropathy (CAN). This study aimed to examine whether short-term progression of CAC is increased in persons with type 1 diabetes compared to matched controls and if CAN increases risk of CAC progression.METHODS: Fifty-three normoalbuminuric persons with long-term type 1 diabetes (20 with CAN) were matched in a 1:2 ratio with 106 controls without diabetes according to age, sex and baseline CAC. All were examined twice with cardiac computed tomography scans. Progression of CAC was defined as a value ≥2.5 between the square root-transformed values of follow-up and baseline CAC volume scores.RESULTS: The participants were examined median (interquartile range) of 25 (23-27) months (type 1 diabetes) and 29 (25-33) months (controls) apart. In multivariable logistic regression, participants with type 1 diabetes had an odds ratio of 3.3 (95% CI 1.3-8.2, p = 0.01) for CAC progression. CAN did not increase progression of CAC (p = 0.64).CONCLUSIONS: Progression of CAC was increased in well-treated, normoalbuminuric persons with type 1 diabetes compared to matched controls without diabetes, suggesting that type 1 diabetes is a risk factor for short-term progression. This finding could explain some of the increased morbidity and mortality observed in persons with type 1 diabetes, but it does not specifically explain the increased CV risk in persons with CAN.

KW - Calcium/metabolism

KW - Cardiovascular Diseases/complications

KW - Case-Control Studies

KW - Coronary Artery Disease/diagnosis

KW - Diabetes Mellitus, Type 1/complications

KW - Disease Progression

KW - Early Diagnosis

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Risk Factors

KW - Serum Albumin/metabolism

U2 - 10.1016/j.diabres.2018.04.027

DO - 10.1016/j.diabres.2018.04.027

M3 - Journal article

C2 - 29679631

SN - 0168-8227

VL - 141

SP - 18

EP - 25

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

ER -