Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Cardiovasc Diabetol. 2019 May 4;18(1):58. doi: 10.1186/s12933-019-0861-x.
The aim was to assess coronary atherosclerosis, plaque morphology and associations to cardiovascular risk factors and epicardial adipose tissue (EAT) in patients with long duration of type 1 diabetes mellitus (T1DM).
Eighty-eight patients with ≥ 45 year T1DM duration and 60 controls underwent coronary CT angiography (CCTA) for evaluation of coronary artery plaque volume (total, calcified or mixed/soft), coronary artery calcification score (CAC) and EAT.
Plaques were detected in 75 (85%) T1DM patients and 28 (47%) controls, p < 0.01. Median (interquartile range) plaque volume (mm) in T1DM vs. controls was: 21.0 (1.0-66.0) vs. 0.2 (0.0-7.1), p < 0.01 for calcified, 0.0 (0.0-8.7) vs. 0.0 (0.0-0.0), p < 0.01 for soft/mixed and 29.5 (3.9-95.8) vs. 0.4 (0.0-7.4), p < 0.01 for total plaque volume. Median CAC was 128 (13-671) vs. 1 (0.0-39.0), p < 0.01 in T1DM vs. controls. Median EAT volume did not differ between the groups; 52.3 (36.1-65.5) cm vs. 55 (38.3-79.6), p = 0.20. No association between CAC or plaque volumes and EAT were observed. Low time-weighted LDL-cholesterol and HbA1c for 30 years were associated with having plaque volume < 25th percentile, OR (95% CI) 0.18 (0.05-0.70), p = 0.01 and 0.45 (0.20-1.00), p < 0.05, respectively. Time-weighted LDL-c was linearly associated with CAC (beta 0.82 (95% CI 0.03-1.62), p = 0.04) and total plaque volume (beta 0.77 (95% CI 0.19-1.36), p = 0.01).
Long-term survivors of T1DM have a higher prevalence of coronary atherosclerosis compared to controls. Low LDL-cholesterol and HbA1c over time have a protective effect on coronary atherosclerosis. EAT volume was not associated with coronary atherosclerosis in T1DM patients.
评估长期 1 型糖尿病（T1DM）患者的冠状动脉粥样硬化、斑块形态以及与心血管危险因素和心外膜脂肪组织（EAT）的相关性。
88 例 T1DM 病程≥45 年的患者和 60 例对照者接受冠状动脉 CT 血管造影（CCTA）评估冠状动脉斑块体积（总、钙化或混合/软斑块）、冠状动脉钙化评分（CAC）和 EAT。
T1DM 患者中 75 例（85%）和对照者中 28 例（47%）检出斑块，p<0.01。T1DM 与对照者的中位数（四分位距）斑块体积（mm）分别为：钙化斑块 21.0（1.0-66.0）与 0.2（0.0-7.1），p<0.01；软/混合斑块 0.0（0.0-8.7）与 0.0（0.0-0.0），p<0.01；总斑块体积 29.5（3.9-95.8）与 0.4（0.0-7.4），p<0.01。T1DM 与对照者的中位数 CAC 分别为 128（13-671）与 1（0.0-39.0），p<0.01。两组间 EAT 体积无差异；52.3（36.1-65.5）cm 与 55（38.3-79.6）cm，p=0.20。未观察到 CAC 或斑块体积与 EAT 之间存在相关性。30 年来 LDL-C 的时间加权平均值和 HbA1c 与斑块体积<第 25 百分位相关，OR（95%CI）分别为 0.18（0.05-0.70），p=0.01 和 0.45（0.20-1.00），p<0.05。时间加权 LDL-c 与 CAC（β0.82（95%CI 0.03-1.62），p=0.04）和总斑块体积（β0.77（95%CI 0.19-1.36），p=0.01）呈线性相关。
长期 1 型糖尿病生存者的冠状动脉粥样硬化患病率高于对照者。随时间推移 LDL-C 和 HbA1c 水平较低对冠状动脉粥样硬化具有保护作用。EAT 体积与 T1DM 患者的冠状动脉粥样硬化无相关性。
