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Vascular or chronological age: which is the better marker to estimate the cardiovascular risk in patients with type 1 diabetes?

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Abstract

Aims

To evaluate whether using vascular age (VA) instead of chronological age (CA) in the Framingham score would enhance the cardiovascular disease (CVD) risk estimation in patients with type 1 diabetes (T1D).

Methods

This was a cross-sectional study comprising 58 T1D patients and 38 control subjects matched by age, gender and body mass index. To estimate the VA, we used carotid intima-media thickness normality estimation tables that took into account age, gender and ethnic group.

Results

Compared to the control group, T1D patients had an older VA with an 8.8-year difference (p < 0.001), a higher CVD risk stratification comparing CA and VA (p < 0.001). In the group of T1D patients, there was a 9.4-year difference between VA and CA (p < 0.001), mainly due to a greater increase in women compared to men (11.2 vs 6.4 years, respectively) and 29.3 % of the patients with T1D increased their CVD risk stratification using VA as a parameter. Still, in the group of T1D patients, women had a higher increase in VA for each 1-year increase in CA than men (1.2 years vs 0.8 years, respectively, p < 0.001). This difference persisted as we compared women with T1D with women in the control group (0.4 years), p = 0.006.

Conclusions

T1D patients have an increased VA, a marker of subclinical atherosclerosis. The use of VA age may contribute to the identification of high CVD risk in T1D. In patients with T1D, a younger chronological age, particularly in women, might not be a protective factor for CVD.

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Author information

Authors and Affiliations

  1. Endocrinology Department, University Hospital of Fluminense Federal University, Rio de Janeiro, Brazil

    Carlos Roberto Moraes de Andrade Jr

  2. Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, Avenida 28 de Setembro, 77, 3° andar, Rio de Janeiro, RJ, CEP 20.551-030, Brazil

    Carlos Roberto Moraes de Andrade Jr, Eliete Leão Clemente Silva, Maria de Fátima Bevilaqua da Matta & Marília Brito Gomes

  3. Department of Internal Medicine, Cardiology Unit, State University Hospital of Rio de Janeiro, Rio de Janeiro, Brazil

    Marcia Bueno Castier

  4. Epidemiology and Biomaths, University Hospital of Fluminense Federal University, Rio de Janeiro, Brazil

    Maria Luiza Garcia Rosa

  5. Avenida Prof. Florestan Fernandes 1036 Bl.16 ap.503, Camboinhas, Niterói, Rio de Janeiro, CEP 24358-580, Brazil

    Carlos Roberto Moraes de Andrade Jr

Authors
  1. Carlos Roberto Moraes de Andrade Jr
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  2. Eliete Leão Clemente Silva
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  3. Maria de Fátima Bevilaqua da Matta
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  4. Marcia Bueno Castier
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  5. Maria Luiza Garcia Rosa
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  6. Marília Brito Gomes
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Corresponding author

Correspondence to Carlos Roberto Moraes de Andrade Jr.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This Study has been Reviewed by the ethical committee of Pedro Ernesto University Hospital, Rio de Janeiro State University and has therefore been performed according to the ethical standards laid down in an appropriate version of 1964 Declaration of Helsinki.

Funding

This work was supported by grants from Fundação do Amparo à Pesquisa do Estado do Rio de Janeiro, and Conselho Nacional de Desenvolvimento Científico e Tecnológico do Brasil.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study. Details that might disclose the identity of study participants have been omitted.

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de Andrade , C.R.M., Silva, E.L.C., da Matta, M.F.B. et al. Vascular or chronological age: which is the better marker to estimate the cardiovascular risk in patients with type 1 diabetes?. Acta Diabetol 53, 925–933 (2016). https://doi.org/10.1007/s00592-016-0891-8

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  • DOI: https://doi.org/10.1007/s00592-016-0891-8

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