20-LB: Time since Diagnosis Is Associated with Subclinical Cardiovascular Disease in Adults with Type 1 Diabetes

Individuals with type 1 diabetes have increased morbidity and mortality due to cardiovascular disease (CVD), being the cause of death in 40% of these patients. A high proportion develop CVD before 50 years. Objective of this study was to explore factors associated with subclinical cardiovascular disease using aortic stiffness markers including pulse wave velocity (APWv), aortic augmentation index (AIx) and carotid intima-media thickness (cIMT).

Material and Methods: Cross-sectional study carried out in the Type 1 Diabetes Clinic of a tertiary center in Mexico City. Demographic and biochemical variables were evaluated. Anthropometric and body composition analysis was performed using bioelectrical impedance. Assessment of the APWv and cIMT was carried out using ultrasound and AIx with aortic tonometry. Statistical analyses were performed using SPPS version 21, a P value < 0.05 was considered significant.

Results: 49 patients have been included, 25(51%)women. Mean age of the participants was 38.1±11.9 years. Mean age at diagnosis was 17± 8.8 years and time median time since diagnosis 20(range 6 to 43) 17± 8.8 years. A positive correlation was found between APWv and time since diagnosis, total cholesterol and visceral adipose tissue and a negative association with eGFR. The AIx showed positive correlation with time since diagnosis, age, body mass index (BMI) and systolic blood pressure. The cIMT showed a positive correlation with time since diagnosis, BMI and a negative association with eGFR. We did not find associations between the stiffness markers and A1c or albuminuria. In the linear regression analysis only time since diagnosis remained significantly and independently associated with the AIx after adjusting for age, BMI and systolic blood pressure.

Conclusions: This preliminary report shows that time since type 1 diabetes diagnosis is positively and independently associated with markers of aortic rigidity (AIx) in this population of young adults with type 1 diabetes.