Introduction and Objective: Early vascular aging (EVA), based on vascular age gap (VAG), reflects excess vascular aging beyond chronological age, but its clinical relevance in type 1 diabetes (T1D) remains unclear. We aimed to characterize EVA based on carotid intima-media thickness (cIMT) and its associations with microvascular complications in adults with T1D.Methods: This cross-sectional study included adults with T1D without clinical macrovascular disease or carotid plaque. Vascular age was derived from right common carotid artery cIMT using population-based reference equations; EVA was defined as VAG ≥5.7 years. Clinical data, laboratory parameters, skin autofluorescence, and diabetic complications were assessed. Multivariable linear and logistic regression models were applied.Results: We included 569 adults with T1D [median age 35 (28-43 years), diabetes duration 15 (10-25) years]. EVA affected 54.1% of participants. People with EVA had longer diabetes duration [16 (12-30) vs. 14 (9-20)years], more frequent hypertension (39.9 vs. 30.3%), and higher skin autofluorescence [2.30 (1.90-2.70) vs. 2.20 (1.80-2.50) AU], while HbA1c was similar. EVA was more prevalent among participants with retinopathy (49.4 vs. 31.4%) and nephropathy (22.4 vs. 10.3%). VAG increased by 3.3 years per 10 years of diabetes duration (p=0.001), 5.0 years in current smokers (p=0.01), and 3.8 years per 1-AU increase in skin autofluorescence (p=0.03). In logistic models adjusted for age, diabetes duration, blood pressure, body mass index, HbA1c, lipids, and smoking., a 10-year increase in VAG associated with any retinopathy (OR 1.14, 95% CI 1.02-1.27; p=0.025), proliferative retinopathy (OR 1.22, 95% CI 1.10-1.34; p=0.003), and nephropathy (OR 1.22, 95% CI 1.10-1.34; p=0.005).Conclusion: In adults with T1D without macroangiopathy, EVA assessed by cIMT is frequent and independently associates with diabetes duration, smoking, and advanced glycation, as well as with retinopathy and nephropathy.
M. Kulecki: None. D. Naskret: Speaker’s Bureau; Ended; AstraZeneca, Novo Nordisk, Boehringer Ingelheim International GmbH, Bayer AG, Sanofi, Eli Lilly and Company. S. Pilacinski: None. A. Duda-Sobczak: None. A. Gandecka-Pempera: None. D. Zozulinska-Ziólkiewicz: Advisory Panel; Current; Abbott Diabetes. Speaker’s Bureau; Current; Abbott Diabetes, Eli Lilly and Company, Novo Nordisk, Sanofi, Dexcom, Inc. Advisory Panel; Current; Medtronic. Speaker’s Bureau; Current; Medtronic, Servier Laboratories.
Source link
Leave a Reply