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Early atherosclerosis relates to urinary albumin excretion and cardiovascular risk factors in adolescents with type 1 diabetes

Higher urinary albumin excretion, even within the normal range, is associated with early atherosclerosis

Authors:
Maftei O, Pena AS, Sullivan T, Jones TW, Donaghue KC, Cameron FJ, Davis E, et al.

Authors notes:
Diabetes Care. 2014;37(11):3069-3075

Keywords:
Cardiovascular disease, renal disease, albumin, atherosclerosis, type 1 diabetes

Abstract:
The origins of cardiovascular and renal disease in type 1 diabetes begin during childhood.

We aimed to evaluate carotid (cIMT) and aortic intima-media thickness (aIMT) and their relationship with cardiovascular risk factors and urinary albumin excretion in adolescents with type 1 diabetes in the Adolescent Type 1 Diabetes cardio-renal Intervention Trial (AdDIT).

In type 1 diabetic subjects, mean/maximal aIMT, but not mean/maximal cIMT, was greater than in control subjects. Mean/maximal aIMT related to urinary albumin-to-creatinine ratio, LDL cholesterol, and age, independent of other variables.

Mean/maximal cIMT was greater in males, and mean cIMT related independently to systolic blood pressure.

Vascular smooth muscle function related to aIMT and cIMT but not to urinary albumin excretion.

aIMT may be a more sensitive marker of atherosclerosis than cIMT in type 1 diabetes during mid-adolescence.

Higher urinary albumin excretion, even within the normal range, is associated with early atherosclerosis and should direct clinical attention to modifiable cardiovascular risk factors.