Aortic intima media thickness in children and adolescents with type 1 diabetes : A systematic review

Journal article


Gow, Megan L., Varley, Benjamin J., Nasir, Reeja F., Skilton, Michael R. and Craig, Maria E.. (2022). Aortic intima media thickness in children and adolescents with type 1 diabetes : A systematic review. Pediatric Diabetes. 23(4), pp. 489-498. https://doi.org/10.1111/pedi.13322
AuthorsGow, Megan L., Varley, Benjamin J., Nasir, Reeja F., Skilton, Michael R. and Craig, Maria E.
Abstract

Aims
Greater aortic intima media thickness (aIMT), a marker of subclinical atherosclerosis, can identify individuals at risk of CVD. This systematic review with meta-analysis compared aIMT in youth with type 1 diabetes and healthy controls.

Methods
A systematic search of published literature (to July 2021) was undertaken using electronic databases MEDLINE, EMBASE, Scopus, CINAHL and AMED. Eligible studies reported aIMT in participants aged <20 years with type 1 diabetes and healthy controls. Meta-analysis was used to combine outcome data, presented as forest plots. Moderator analysis and metaregression were conducted to identify study and participant characteristics associated with aIMT. Publication bias was assessed by funnel plot inspection.

Results
Meta-analysis of nine studies (n = 1030 with type 1 diabetes and n = 498 healthy control participants) indicated, with high heterogeneity (I2 98%), that youth with type 1 diabetes have higher aIMT compared with healthy controls (mean difference [95% CIs]: 0.11 [0.04, 0.18] mm, P = 0.003). Factors associated with greater aIMT in type 1 diabetes compared to controls included: use of a phased array probe versus linear array probe; longer diabetes duration; higher insulin dose; higher BMI z score and waist circumference; higher LDL cholesterol; higher triglycerides; and higher diastolic blood pressure.

Conclusions
Type 1 diabetes in youth is associated with higher aIMT compared with healthy control individuals. Longer duration of diabetes and major CVD risk factors were also associated with higher aIMT. Together, these findings provide a strong rationale for targeting modifiable risk factors in CVD prevention. Registered in PROSPERO on 8 August 2019 (CRD42019137559).

Keywordsaortic intima media thickness; subclinical atherosclerosis; systematic review; type 1 diabetes; youth
Year2022
JournalPediatric Diabetes
Journal citation23 (4), pp. 489-498
PublisherJohn Wiley & Sons Ltd
ISSN1399-543X
Digital Object Identifier (DOI)https://doi.org/10.1111/pedi.13322
PubMed ID35191150
Scopus EID2-s2.0-85124886369
PubMed Central IDPMC9303881
Open accessPublished as ‘gold’ (paid) open access
Page range489-498
FunderNational Health and Medical Research Council (NHMRC)
Research Training Program Scholarship (RTP), Australian Government
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online21 Feb 2022
Publication process dates
Accepted03 Feb 2022
Deposited22 Oct 2023
Grant IDAPP1158876
APP1136735
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