Published in:
01-12-2016 | Original Article
Vascular or chronological age: which is the better marker to estimate the cardiovascular risk in patients with type 1 diabetes?
Published in: Acta Diabetologica | Issue 6/2016
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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.