Early Markers of Cardiovascular Disease Associated with Clinical Data and Autosomal Ancestry in Patients with Type 1 Diabetes: A Cross-Sectional Study in an Admixed Brazilian Population.

Roberta Maria Duailibe Ferreira Reis,Carlos Alberto Azulay Junior,Maria Da Glória Tavares,Vandilson Rodrigues,Sabrina Da Silva Pereira Damianse,Paulo Cézar Dias Ferraz,Marcelo Magalhães,Jacqueline Ribeiro,Ana Gregória Almeida,Conceição Parente,Viviane Chaves De Carvalho Rocha,Rossana Santiago De Sousa Azulay,Débora Cristina Ferreira Lago,Marília Brito Gomes,Dayse Aparecida Silva,Gilvan Cortês Nascimento,Carla Souza Sobral,Joana França,Manuel Dos Santos Faria

doi:10.3390/genes13020389

Abstract

Patients with type 1 diabetes (T1D) have a higher risk of developing cardiovascular disease (CVD), which is a major cause of death in this population. This study investigates early markers of CVD associated with clinical data and autosomal ancestry in T1D patients from an admixed Brazilian population. A cross-sectional study was conducted with 99 T1D patients. The mean age of the study sample was 27.6 years and the mean duration of T1D was 14.4 years. The frequencies of abnormalities of the early markers of CVD were 19.6% in the ankle-brachial index (ABI), 4.1% in the coronary artery calcium score (CACS), and 5% in the carotid Doppler. A significant percentage of agreement was observed for the comparison of the frequency of abnormalities between CACS and carotid Doppler (92.2%, p = 0.041). There was no significant association between the level of autosomal ancestry proportions and early markers of CVD. The ABI was useful in the early identification of CVD in asymptomatic young patients with T1D and with a short duration of disease. Although CACS and carotid Doppler are non-invasive tests, carotid Doppler is more cost-effective, and both have limitations in screening for CVD in young patients with a short duration of T1D. We did not find a statistically significant relationship between autosomal ancestry proportions and early CVD markers in an admixed Brazilian population.

Highlights

The incidence of cardiovascular disease (CVD) is two to four times higher in patients with type 1 diabetes (T1D) than in the general population [1,2]
Subclinical CVD has usually been evaluated through non-invasive methods, such as computed tomography with the coronary artery calcium score (CACS), carotid Doppler ultrasound, and ankle-brachial index (ABI)
ABI showed the highest prevalence of alterations in our series, making it useful in the early identification of CVD in young asymptomatic patients with T1D and with a short period of disease

Summary

Introduction

The incidence of cardiovascular disease (CVD) is two to four times higher in patients with type 1 diabetes (T1D) than in the general population [1,2]. Advances have been made in the management of microvascular complications in patients with T1D, but there has been little progress in reducing CVD [4]. The early identification of CVD could reduce the morbidity and mortality of T1D patients. Subclinical CVD has usually been evaluated through non-invasive methods, such as computed tomography with the coronary artery calcium score (CACS), carotid Doppler ultrasound, and ankle-brachial index (ABI). Changes in these tests have been associated with an increase in CVD and may be useful in the early identification of this pathology [6,7]

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