Mesa Alex, Puig-Jové Carlos, Pané Adriana, Vinagre Irene, López-Quesada Eva, Meler Eva, Alonso-Carril Núria, Quirós Carmen, Amor Antonio J, Perea Verónica
Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Diabetes Unit, Endocrinology and Nutrition Department, ICMDM, Hospital Clínic de Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Spain.
Cardiovasc Diabetol. 2025 Apr 9;24(1):160. doi: 10.1186/s12933-025-02719-3.
Preeclampsia (PE) and type 1 diabetes (T1D) are significant risk factors for cardiovascular disease (CVD), but their combined effect on atherosclerosis progression has not been fully explored. This study aimed to evaluate the impact of T1D and PE on the progression of atherosclerosis.
Prospective cohort study of 112 women divided into four groups: T1D + /PE + (n = 28), T1D + /PE- (n = 28), T1D-/PE + (n = 28), and T1D-/PE- (n = 28). Participants underwent an initial assessment and a follow-up visit five years later, which included anthropometric evaluation, blood tests, and carotid ultrasound. Atherosclerosis progression was defined as an increase in carotid plaque number or the occurrence of a cardiovascular event (CVE) during follow-up (fatal or non-fatal ischemic heart disease, fatal or non-fatal stroke, and/or heart failure).
A total of 104 women (92.9%) completed the follow-up (54 with T1D, mean age at inclusion 45.2 ± 7.6 years, mean follow-up 5.3 ± 1.2 years). An increase in carotid plaques was identified in 34 women (32.7%), and 3 CVEs (2.9%) occurred. In women with T1D, a history of PE was associated with a twofold increase in atherosclerosis progression (57.7% vs 25.0%, p = 0.015). In multivariate models adjusted for age, T1D and cardiovascular risk factors, PE [OR 4.97 (1.61-15.29), p = 0.005] and PE + T1D [OR 7.69 (1.25-47.29), p = 0.028] were independently associated with atherosclerosis progression.
PE was a strong independent predictor of atherosclerosis progression over a 5-year follow-up period, with an additive effect in T1D. These findings highlight preeclampsia as a significant CVD risk enhancer in young women with T1D.
子痫前期（PE）和1型糖尿病（T1D）是心血管疾病（CVD）的重要危险因素，但它们对动脉粥样硬化进展的联合影响尚未得到充分研究。本研究旨在评估T1D和PE对动脉粥样硬化进展的影响。
对112名女性进行前瞻性队列研究，分为四组：T1D+/PE+（n = 28）、T1D+/PE-（n = 28）、T1D-/PE+（n = 28）和T1D-/PE-（n = 28）。参与者接受了初始评估，并在五年后进行了随访，包括人体测量评估、血液检查和颈动脉超声检查。动脉粥样硬化进展定义为随访期间颈动脉斑块数量增加或发生心血管事件（CVE）（致命或非致命性缺血性心脏病、致命或非致命性中风和/或心力衰竭）。
共有104名女性（92.9%）完成了随访（54名患有T1D，纳入时平均年龄45.2±7.6岁，平均随访5.3±1.2年）。34名女性（32.7%）出现颈动脉斑块增加，3例发生CVE（2.9%）。在患有T1D的女性中，有PE病史与动脉粥样硬化进展增加两倍相关（57.7%对25.0%，p = 0.015）。在根据年龄、T1D和心血管危险因素进行调整的多变量模型中，PE[比值比4.97（1.61 - 15.29），p = 0.005]和PE + T1D[比值比7.69（1.25 - 47.29），p = 0.028]与动脉粥样硬化进展独立相关。
在5年的随访期内，PE是动脉粥样硬化进展的强有力独立预测因素，在T1D中具有累加效应。这些发现突出了子痫前期是患有T1D的年轻女性中重要的CVD风险增强因素。
