C Viñals1, I Conget1,2,3, A Pané1, L Boswell1, V Perea4, A J Blanco1,3, S Ruiz1, M Giménez1,2,3, I Vinagre1,3, E Esmatjes1,2,3, E Ortega1,3, A J Amor1. 1. Endocrinology and Nutrition Dpt. Hospital Clínic de Barcelona, Spain. 2. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain. 3. Institut d'investigacions biomèdiques August Pi i Sunyer. 4. Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain.
Abstract
BACKGROUND AND AIMS: Tools to detect type 1 diabetes (T1D) individuals at overt cardiovascular disease (CVD) risk are scarce. We aimed to assess the usefulness of the score "Steno Type 1 Risk Engine" (Steno-Risk) to identify T1D patients with advanced carotid atherosclerosis. MATERIAL AND METHODS: T1D patients without CVD with at least one of the following were included: ≥40 years, diabetic nephropathy, or diabetes duration ≥10 years with ≥1 CVD risk factor. Intima-media thickness (IMT) and plaque presence (IMT ≥1.5 mm) were assessed by standardized B-mode ultrasonography. Steno-Risk was used to estimate 10-year risk (<10% low; 10-20% moderate; ≥20% high-risk). Associations between Steno-risk and preclinical atherosclerosis were assessed after adjusting for other CVD risk factors. RESULTS: We evaluated 302 patients (55% men, age 47.8 ± 9.8 years, T1D duration 26.3 ± 9.3 years). The prevalence of carotid plaque and ≥ 2 plaques were 36.4% and 19.2%, respectively; without sex differences. Age (57.4 ± 7.4 vs 37.1 ± 6.2 years), T1D duration (31.3 ± 10.4 vs 21.5 ± 7.1 years), hypertension (52.3% vs 6.3%), nephropathy (25.6% vs 5.1%) and retinopathy (53.5% vs 32.9%) were higher in high-risk (n = 86) vs low-risk participants (n = 79; P < 0.001 for all). Preclinical atherosclerosis (IMT and plaque) increased in parallel with Steno-Risk (P < 0.001). In logistic regression analysis, both age ≥ 40 years and Steno-Risk ≥20% were associated with the presence of plaque (OR 4.22 [1.57-11.36] and 3.79 [1.61-6.80]; respectively), but only high Steno-Risk remained independently associated with ≥2 plaques (OR 3.31 [1.61-6.80]). CONCLUSION: Steno-risk is independently associated with preclinical atherosclerosis. Further studies are needed to ascertain its usefulness in this high-risk population. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND AND AIMS: Tools to detect type 1 diabetes (T1D) individuals at overt cardiovascular disease (CVD) risk are scarce. We aimed to assess the usefulness of the score "Steno Type 1 Risk Engine" (Steno-Risk) to identify T1D patients with advanced carotid atherosclerosis. MATERIAL AND METHODS: T1D patients without CVD with at least one of the following were included: ≥40 years, diabetic nephropathy, or diabetes duration ≥10 years with ≥1 CVD risk factor. Intima-media thickness (IMT) and plaque presence (IMT ≥1.5 mm) were assessed by standardized B-mode ultrasonography. Steno-Risk was used to estimate 10-year risk (<10% low; 10-20% moderate; ≥20% high-risk). Associations between Steno-risk and preclinical atherosclerosis were assessed after adjusting for other CVD risk factors. RESULTS: We evaluated 302 patients (55% men, age 47.8 ± 9.8 years, T1D duration 26.3 ± 9.3 years). The prevalence of carotid plaque and ≥ 2 plaques were 36.4% and 19.2%, respectively; without sex differences. Age (57.4 ± 7.4 vs 37.1 ± 6.2 years), T1D duration (31.3 ± 10.4 vs 21.5 ± 7.1 years), hypertension (52.3% vs 6.3%), nephropathy (25.6% vs 5.1%) and retinopathy (53.5% vs 32.9%) were higher in high-risk (n = 86) vs low-risk participants (n = 79; P < 0.001 for all). Preclinical atherosclerosis (IMT and plaque) increased in parallel with Steno-Risk (P < 0.001). In logistic regression analysis, both age ≥ 40 years and Steno-Risk ≥20% were associated with the presence of plaque (OR 4.22 [1.57-11.36] and 3.79 [1.61-6.80]; respectively), but only high Steno-Risk remained independently associated with ≥2 plaques (OR 3.31 [1.61-6.80]). CONCLUSION: Steno-risk is independently associated with preclinical atherosclerosis. Further studies are needed to ascertain its usefulness in this high-risk population. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
Steno Type 1 Risk Engine; cardiovascular disease; carotid atherosclerosis; type 1 diabetes; vascular ultrasonography
Authors: Bruno Lapauw; Tine De Backer; Simon Helleputte; Luc Van Bortel; Francis Verbeke; Jos Op 't Roodt; Patrick Calders Journal: Cardiovasc Diabetol Date: 2022-06-09 Impact factor: 8.949