No correlation between carotid intima-media thickness and long-term glycemic control in individuals with type 1 diabetes

Jussi Inkeri; Valma Harjutsalo; Juha Martola; Jukka Putaala; Per-Henrik Groop; Daniel Gordin; Lena M Thorn; FinnDiane Study Group

doi:10.1007/s00592-023-02211-y

No correlation between carotid intima-media thickness and long-term glycemic control in individuals with type 1 diabetes

Acta Diabetol. 2024 Apr;61(4):441-449. doi: 10.1007/s00592-023-02211-y. Epub 2023 Dec 10.

Authors

Jussi Inkeri^{1

2

3

4}, Valma Harjutsalo^{2

4

5}, Juha Martola^{1

6}, Jukka Putaala⁷, Per-Henrik Groop^{8

9

10

11}, Daniel Gordin^#^{3

5}, Lena M Thorn^#^{2

4

12}; FinnDiane Study Group

Collaborators

FinnDiane Study Group:
S Koivula, T Uggeldahl, T Forslund, A Halonen, A Koistinen, P Koskiaho, M Laukkanen, J Saltevo, M Tiihonen, S M Forsen, H Granlund, A-C Jonsson, B Nyroos, P Kinnunen, A Orvola, T Salonen, A Vähänen, R Paldanius, M Riihelä, L Ryysy, H Laukkanen, P Nyländen, A Sademies, S Anderson, B Asplund, U Byskata, P Liedes, M Kuusela, T Virkkala, A Nikkola, E Ritola, M Niska, H Saarinen, E Oukko-Ruponen, T Virtanen, A Lyytinen, H Kari, T Simonen, A Kaprio, J Kärkkäinen, B Rantaeskola, P Kääriäinen, J Haaga, A-L Pietiläinen, S Klemetti, T Nyandoto, E Rontu, S Satuli-Autere, R Toivonen, H Virtanen, R Ahonen, M Ivaska-Suomela, A Jauhiainen, M Laine, T Pellonpää, R Puranen, A Airas, J Laakso, K Rautavaara, M Erola, E Jatkola, R Lönnblad, A Malm, J Mäkelä, E Rautamo, P Hentunen, J Lagerstam, M Feodoroff, D Gordin, O Heikkilä, K Hietala, J Fagerudd, M Korolainen, L Kyllönen, J Kytö, S Lindh, K Pettersson-Fernholm, M Rosengård-Bärlund, A Sandelin, L Thorn, J Tuomikangas, T Vesisenaho, J Wadén, V Sipilä, T Kalliomäki, J Koskelainen, R Nikkanen, N Savolainen, H Sulonen, E Valtonen, L Norvio, A Hämäläinen, E Toivanen, A Parta, I Pirttiniemi, S Aranko, S Ervasti, R Kauppinen-Mäkelin, A Kuusisto, T Leppälä, K Nikkilä, L Pekkonen, K Nuorva, M Tiihonen, S Jokelainen, K Kananen, M Karjalainen, P Kemppainen, A-M Mankinen, A Reponen, M Sankari, H Stuckey, P Suominen, A Lappalainen, M Liimatainen, J Santaholma, A Aimolahti, E Huovinen, V Ilkka, M Lehtimäki, E Pälikkö-Kontinen, A Vanhanen, E Koskinen, T Siitonen, E Huttunen, R Ikäheimo, P Karhapää, P Kekäläinen, M Laakso, T Lakka, E Lampainen, L Moilanen, S Tanskanen, L Niskanen, U Tuovinen, I Vauhkonen, E Voutilainen, T Kääriäinen, E Isopoussu, E Kilkki, I Koskinen, L Riihelä, T Meriläinen, P Poukka, R Savolainen, N Uhlenius, A Mäkelä, M Tanner, L Hyvärinen, K Lampela, S Pöykkö, T Rompasaari, S Severinkangas, T Tulokas, P Erola, L Härkönen, P Linkola, T Pekkanen, I Pulli, E Repo, T Granlund, K Hietanen, M Porrassalmi, M Saari, T Salonen, M Tiikkainen, I-M Jousmaa, J Rinne, A Mäkelä, P Eloranta, H Lanki, S Moilanen, M Tilly-Kiesi, A Gynther, R Manninen, P Nironen, M Salminen, T Vänttinen, I Pirttiniemi, A-M Hänninen, U-M Henttula, P Kekäläinen, M Pietarinen, A Rissanen, M Voutilainen, A Burgos, K Urtamo, E Jokelainen, P-L Jylkkä, E Kaarlela, J Vuolaspuro, L Hiltunen, R Häkkinen, S Keinänen-Kiukaanniemi, R Ikäheimo, H Haapamäki, A Helanterä, S Hämäläinen, V Ilvesmäki, H Miettinen, P Sopanen, L Welling, V Sevtsenko, M Tamminen, M-L Holmbäck, B Isomaa, L Sarelin, P Ahonen, P Merisalo, E Muurinen, K Sävelä, M Kallio, B Rask, S Rämö, A Holma, M Honkala, A Tuomivaara, R Vainionpää, K Laine, K Saarinen, T Salminen, P Aalto, E Immonen, L Juurinen, A Alanko, J Lapinleimu, P Rautio, M Virtanen, M Asola, M Juhola, P Kunelius, M-L Lahdenmäki, P Pääkkönen, M Rautavirta, T Pulli, P Sallinen, M Taskinen, E Tolvanen, T Tuominen, H Valtonen, A Vartia, S-L Viitanen, O Antila, E Korpi-Hyövälti, T Latvala, E Leijala, T Leikkari, M Punkari, N Rantamäki, H Vähävuori, T Ensala, E Hussi, R Härkönen, U Nyholm, J Toivanen, A Vaden, P Alarotu, E Kujansuu, H Kirkkopelto-Jokinen, M Helin, S Gummerus, L Calonius, T Niskanen, T Kaitala, T Vatanen, P Hannula, I Ala-Houhala, R Kannisto, T Kuningas, P Lampinen, M Määttä, H Oksala, T Oksanen, A Putila, H Saha, K Salonen, H Tauriainen, S Tulokas, T Kivelä, L Petlin, L Savolainen, A Artukka, I Hämäläinen, L Lehtinen, E Pyysalo, H Virtamo, M Viinikkala, M Vähätalo, K Breitholz, R Eskola, K Metsärinne, U Pietilä, P Saarinen, R Tuominen, S Äyräpää, K Mäkinen, P Sopanen, S Ojanen, E Valtonen, H Ylönen, M Rautiainen, T Immonen, I Isomäki, R Kroneld, L Mustaniemi, M Tapiolinna-Mäkelä, S Bergkulla, U Hautamäki, V-A Myllyniemi, I Rusk

Affiliations

¹ Radiology, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
² Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, P.O. Box 63 (C318b), 00014, Helsinki, Finland.
³ Minerva Foundation Institute for Medical Research, Helsinki, Finland.
⁴ Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland.
⁵ Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁶ Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
⁷ Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁸ Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, P.O. Box 63 (C318b), 00014, Helsinki, Finland. per-henrik.groop@helsinki.fi.
⁹ Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland. per-henrik.groop@helsinki.fi.
¹⁰ Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. per-henrik.groop@helsinki.fi.
¹¹ Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia. per-henrik.groop@helsinki.fi.
¹² Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

^# Contributed equally.

Abstract

Aims: To determine whether carotid intima-media thickness (CIMT), a surrogate marker of cardiovascular disease (CVD), is associated with long-term blood glucose control in individuals with type 1 diabetes (T1D).

Methods: We recruited 508 individuals (43.4% men; median age 46.1, IQR 37.8-55.9 years) with T1D (median diabetes duration of 30.4, IQR 21.2-40.8 years) in a cross-sectional retrospective sub-study, part of the Finnish Diabetic Nephropathy (FinnDiane) Study. Glycated hemoglobin (HbA_1c) data were collected retrospectively over the course of ten years (HbA_1c-mean_overall) prior to the clinical study visit that included a clinical examination, biochemical sampling, and ultrasound of the common carotid arteries.

Results: Individuals with T1D had a median CIMT of 606 μm (IQR 538-683 μm) and HbA_1c of 8.0% (7.3-8.8%) during the study visit and HbA_1c-mean_overall of 8.0% (IQR 7.3-8.8%). CIMT did not correlate with HbA_1c (p = 0.228) at visit or HbA_1c-mean_overall (p = 0.063). After controlling for relevant factors in multivariable linear regression analysis, only age was associated with CIMT (p < 0.001). After further dividing CIMT into quartiles, no correlation between long-term glucose control and CIMT (%, 1^st 8.1 [IQR 7.2-8.9] vs 4^th 7.9 [7.4-8.7], p = 0.730) was found.

Conclusions: We observed no correlation between long-term blood glucose control and CIMT in individuals with T1D. This finding suggests that the development of early signs of macrovascular atherosclerosis is not strongly affected by the glycemic control in people with T1D.

Keywords: Cardiovascular disease; Carotid intima-media thickness; Glycemic control; Type 1 diabetes.

MeSH terms

Carotid Arteries / diagnostic imaging
Carotid Intima-Media Thickness
Cross-Sectional Studies
Diabetes Mellitus, Type 1* / complications
Diabetes Mellitus, Type 1* / diagnostic imaging
Female
Glycemic Control
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors

Abstract

MeSH terms

Grants and funding