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Coronary artery calcifications and diastolic dysfunction versus visceral fat area in type 1 diabetes
Journal Contribution - Journal Article
Aims Type 1 diabetic patients (T1DM) experience a higher cardiovascular disease and mortality risk than controls. We investigated whether visceral adipose tissue (VAT) contributes to coronary artery calcifications (CAC) and cardiac dysfunction in T1DM. Methods A cross-sectional study of 118 T1DM patients without a history of cardiovascular disease (men/women: 68/50, age 46 ± 12 years, HbA1c 7.6 ± 0.9%, BMI 25.8 ± 4.1 kg/m2) was conducted. CAC and VAT were measured using a CT scan. CAC was scored using the Agatston method. Cardiac functional abnormalities were assessed by echocardiography. Results CAC scored ≥10 in 42% of patients. Systolic function was normal in all, but diastolic dysfunction was present in 75%. Forty-six percent had VAT ≥ 100 cm2. CAC score ≥ 10 occurred more often in subjects with VAT ≥ 100 cm2 (54% vs 31%; p = 0.01). Age (OR = 1.10; p < 0.0001), diabetes duration (OR = 1.10; p = 0.008), gender (OR = 4.28; p = 0.016), LDL-cholesterol (OR = 1.03; p = 0.009) and metabolic syndrome (OR = 5.79; p = 0.005) were independently associated with a CACS ≥ 10. Subjects with CACS ≥ 10 were more prone to have diastolic dysfunction (84 vs 54%; p = 0.03). Factors independently associated with diastolic dysfunction were age (OR = 1.11; p = 0.002), waist circumference (OR = 1.10; p = 0.016) and VAT (OR = 0.99; p = 0.035). Conclusions Excess VAT in T1DM, present in 46%, is associated with diastolic dysfunction and CAC, present in respectively 75% and 42% of patients. Timely detection might improve future cardiovascular risk.
Journal: Journal of Diabetes & its Complications
Pages: 271 - 278
Keywords:Endocrinology & metabolism