Evaluation of Carotis Intima Media Thickness and Cardiac Functions in Children with Type 1 Diabetes Mellitus

Öz

Aim: To evaluate carotid intima-media thickness (CIMT), left cardiac systolic and diastolic functions by echocardiographic method in children followed up with the diagnosis of Type 1 Diabetes Mellitus (DM). Material and Methods: Thirty-one patients with type 1 DM who were followed up at our university for at least 4 years and 19 healthy children as the control group were included in the study. Patients were grouped according to; glycemic control level, duration of illness, gender and compared with the control group. Statistical analyzes were performed using the SPSS for Windows version 17.0 package program. Results: The patient and control groups were similar in terms of age, height, gender, weight, body mass index, systolic and diastolic blood pressure (p>0.05). There was no significant difference between diabetic patients and control group, cardiac systolic and diastolic functions, CIMT values (p>0.05). When the patients were divided into subgroups according to diabetes duration and glycemic control;no significant difference was found between CIMT levels (respectively, p=0.084 and p=0.410). In patients with DM duration ≥8 years, CIMT was found to be 0.54 mm, although it was not statistically significant, it was found to be significantly increased. In the subgroup analysis, left CIMT was found to be significantly increased in diabetic boys compared to control boys and diabetic girls (respectively, p=0.026 and p=0.022). A significant difference was found in the mean CIMT in diabetic boys compared to the diabetic girls group (p=0.042). Conclusion: Increased mean and left CIMT in diabetic men suggested that gender might be an independent risk factor for atherosclerosis. Despite intensive diabetes treatment and glycemic control, Type 1 DM is an important risk factor affecting the cardiovascular system, especially in male gender, even in childhood.

Anahtar Kelimeler

• Type 1 diabetes mellitus
• carotid intima media thickness
• cardiac functions
• childhood

Tip 1 Diyabetli Çocuklarda Kardiyak Fonksiyonlar ile Karotis İntima Media Kalınlığının Değerlendirilmesi

Öz

Amaç: Tip 1 Diyabetes Mellitus (DM) tanısı ile izlenen çocuklarda, karotis intima media kalınlığı (KİMK), sol kardiyak sistolik ve diyastolik fonksiyonları ekokardiyografik yöntem ile değerlendirmek. Gereç ve Yöntemler: Üniversitemizde en az 4 yıldır tip 1 DM tanısı ile izlenen 31 hasta ve kontrol grubu olarak 19 sağlıklı çocuk çalışmaya alınmıştır. Hastalar; glisemik kontrol düzeyleri, hastalık süreleri ve cinsiyetlerine göre gruplandırılarak, kontrol grubuyla karşılaştırıldı. SPSS for Windows version 17.0 paket programı kullanılarak istatistiksel analizler yapıldı. Bulgular: Hasta ve kontrol grubu; yaş, boy, cinsiyet, ağırlık, vücut kütle indeksi, sistolik ve diyastolik kan basıncı bakımından benzerdi (p>0.05). Diyabetli hastalar ve kontrol grubu, kardiyak sistolik ve diyastolik fonksiyonlar, KİMK değerleri arasında anlamlı bir fark yoktu (p>0.05). Hastalar diyabet sürelerine göre ve glisemik kontrole göre alt gruplara ayrıldığında KİMK düzeyleri arasında anlamlı bir fark bulunamadı (sırasıyla, p=0.084 ve p=0.410). DM süresi ≥8 yıl olan hastalarda KİMK 0.54 mm olarak istatistiksel anlamlı olmasa da belirgin artmış olarak bulundu. Alt grup analizinde diyabetik erkeklerde, kontrol grubu erkeklere ve diyabetik kızlara göre sol KİMK anlamlı olarak artmış olarak bulundu (sırasıyla, p=0.026 ve p=0.022). Diyabetik erkeklerde ortalama KİMK kız grubuna göre anlamlı fark saptandı (p=0.042). Sonuç: Diyabetik erkeklerde artış gösteren ortalama ve sol KİMK, ateroskleroz açısından cinsiyetin bağımsız bir risk faktörü olabileceğini düşündürdü. Yoğun diyabet tedavisi ve glisemik kontrolüne rağmen Tip 1 DM özellikle erkek cinsiyette çocukluk çağında dahi kardiyovasküler sistemi etkileyen önemli bir risk faktörüdür.

Anahtar Kelimeler

• Tip 1 diyabetes mellitus
• karotis intima media kalınlığı
• kardiyak fonksiyonlar
• çocukluk çağı

Kaynakça

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