Early onset of subclinical atherosclerosis in young persons with type 1 diabetes

Objective To evaluate the degree of atherosclerosis and its risk factors in adolescents and young adults with type 1 diabetes. Study design We measured carotid artery intima-media thickness (IMT) in 142 subjects with type I diabetes (mean [SD] age = 16.0 [2.6] years) and 87 control subjects (18.8 [3.1] years). Fasting lipid and homocysteine levels, degree of glycemic control, blood pressure, and body mass index were measured in persons with diabetes. Results The mean carotid IMT was greater in persons with diabetes (P = .002). Among subjects with type I diabetes, lipid levels were significantly higher in female subjects compared with male subjects. The mean carotid IMT was significantly higher in persons with a diabetic complication (including hypertension, retinopathy, or microalbuminuria). In male subjects but not female subjects, HDL cholesterol and the LDL/HDL ratio were correlated with carotid IMT. Conclusions Adolescents with type 1 diabetes have increased atherosclerosis compared with control subjects. Risk factors for increased carotid IMT in these younger patients include diabetic complications and HDL cholesterol and the LDL/HDL ratio, which may be sex-specific.