期刊
DIABETES CARE
卷 26, 期 10, 页码 2923-2928出版社
AMER DIABETES ASSOC
DOI: 10.2337/diacare.26.10.2923
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资金
- NCRR NIH HHS [M01 RR00051] Funding Source: Medline
- NHLBI NIH HHS [R01-HL61753] Funding Source: Medline
- NIDDK NIH HHS [P30-DK57516] Funding Source: Medline
OBJECTIVE-Coronary artery disease (CAD) occurs earlier in life and is more often fatal in people with type I diabetes. This excess risk seems to be higher than in those with type 2 diabetes and is poorly explained by conventional risk factors. The role of glycemic control is controversial and has not been previously addressed in a prospective manner using a reliable marker for subclinical CAD, such as coronary artery calcification (CAC), measured by electron beam computed tomography (EBCT). RESEARCH DESIGN AND METHODS-We measured CAC twice during an interval of 2.7 years in 109 men and women with type 1 diabetes (aged 22-50 years). Progression of CAC was found in 21 patients, based on change in the square root-transformed volume score. RESULTS-In multiple logistic regression, CAC progression was associated with baseline hyperglycemia (odds ratio [OR] 7.11, 95% CI 1.38-36.6, P = 0.02), adjusted for the presence of CAC at baseline (P = 0.01), duration of diabetes (P = 0.02), sex (P = 0.09), and age (P = 0.27). There was also a significant interactive effect of higher insulin dose and higher BMI (P = 0.03). CONCLUSIONS-In conclusion, in this young cohort with type I diabetes, suboptimal glycemic control (HbA(1c) >7.5%) was a strong risk factor for progression of CAC. Insulin resistance may also play a role.
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