Diabetes Acute and Chronic Complications III P/FRI/31 Atherosclerotic changes in Japanese patients with type 1 diabetes mellitus during adolescence

Objectives: Diabetes itself is known as an independent risk factor for microand macro-angiopathy. However, only a few studies have examined the onset of cardiovascular complications in Japanese patients with type 1 diabetes mellitus (T1DM). In this study, we investigated atherosclerotic changes in Japanese patients with T1DM in terms of age or duration. Methods: The subjects were 41 patients with prepubertal onset T1DM (17 males) and 26 non-obese non-diabetics as controls (group C: 13 males, 19.7 ± 0.6 year). The T1DM patients were divided into two groups according to Tanner stages (group A: stage 2 to 3; 11.8 ± 2.2 year and group B: stage 4 to 5: 18.2 ± 3.5 year). The obesity index was not significantly different between three groups. We examined parameters of early arteriosclerosis, such as blood pressure, blood flow-dependent vasodilative response (%FMD) and carotid artery intima media complex thickness (IMT), and blood parameters of glycemic and lipids metabolism. Results: i) There was no significant difference in age at onset nor HbA1c between groups A and B. Thus, diabetic duration in group B is significantly longer than group A (p < 0.0001); ii) IMT values in groups A and B were 0.50 ± 0.08 mm and 0.52 ± 0.07 mm respectively, with significant differences in comparison with that of group C (0.45 ± 0.05 mm, p < .05 vs. group A, and p < .005 vs. group B); iii) %FMD value in group B (7.1 ± 3.2%) was significantly lower than those in groups A (10.6 ± 5.4%, p < .05) and C (12.0 ± 5.5%, p < .005); andiv) The atherosclerosis index (AI) in group B is significantly higher than in group A (p < .05). However we can not compare these AI with that in group C, since HDL-C level in T1DM is known to be higher than that in non-diabetics. Conclusion: In non-obese Japanese T1DM patients, age and diabetic-duration dependent atherosclerotic change has already started during adolescence.