Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi Magna Græcia di Catanzaro, Italy.
Azienda Ospedaliero-Universitaria Mater Domini, Università degli Studi Magna Græcia di Catanzaro, Italy.
J Diabetes Sci Technol. 2022 Jul;16(4):904-911. doi: 10.1177/1932296821993178. Epub 2021 Feb 22.
Patients with Type 1 diabetes (T1D) have an increased risk of developing atherosclerosis and complications as myocardial infarction and peripheral artery disease. The thickening of the carotid wall and the brachial artery dysfunction are early and preclinical manifestations of atherosclerosis. The standard marker of care for assessment of glycemic control, glycated hemoglobin, does not associate with early atherosclerosis. We have hypothesized that the emerging metric of glycemic control, as the time spent in the target range (TIR), might be associated with carotid thickening and endothelial dysfunction. According to the hypothesis, we have designed the present research with the aim to evaluate the association between TIR collected in the short and long term and the measures of arterial morphology and function in patients with T1D.
In our study, 70 patients and 35 healthy controls underwent ultrasound vascular study to measure carotid artery intima-media thickness (IMT) and brachial artery endothelial function by the flow-mediated dilation (FMD) technique. TIR was collected by a continuous glucose monitoring system for 2 weeks, 3 months, and 6 months before the vascular study.
Patients with T1D showed a significantly higher carotid IMT (mean±SE, 644±19 vs. 568±29 µ; = 0.04) and a significantly lower FMD (mean±SE, 7.6±0.4 vs. 9.8±0.6%; =0.01) compared with control subjects. No significant relationship between IMT, FMD, and TIR collected in the short and long term emerged.
Young patients with T1D have early vascular abnormalities. The percent of TIR does not correlate with preclinical atherosclerosis. This finding underlines the complexity of the interplay between diabetes and atherosclerosis.
1 型糖尿病（T1D）患者发生动脉粥样硬化和并发症（如心肌梗死和外周动脉疾病）的风险增加。颈动脉壁增厚和肱动脉功能障碍是动脉粥样硬化的早期和临床前表现。评估血糖控制的标准标志物糖化血红蛋白与早期动脉粥样硬化无关。我们假设新兴的血糖控制指标，即目标范围内时间（TIR），可能与颈动脉增厚和内皮功能障碍有关。根据这一假设，我们设计了本研究，旨在评估 T1D 患者短期和长期 TIR 与动脉形态和功能测量之间的关联。
在我们的研究中，70 名患者和 35 名健康对照者接受了超声血管研究，以通过血流介导的扩张（FMD）技术测量颈动脉内膜中层厚度（IMT）和肱动脉内皮功能。TIR 通过连续血糖监测系统在血管研究前 2 周、3 个月和 6 个月收集。
与对照组相比，T1D 患者的颈动脉 IMT（平均值±SE，644±19 与 568±29µ；=0.04）明显较高，FMD（平均值±SE，7.6±0.4 与 9.8±0.6%；=0.01）明显较低。IMT、FMD 与短期和长期 TIR 之间无显著相关性。
年轻的 T1D 患者存在早期血管异常。TIR 的百分比与临床前动脉粥样硬化无关。这一发现强调了糖尿病和动脉粥样硬化之间相互作用的复杂性。
