Dose-Dependent association of cumulative tobacco consumption with the presence of carotid atherosclerosis in individuals with type 1 diabetes.

Autor: Solà C; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain., Viñals C; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain., Serés-Noriega T; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain., Perea V; Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain., Esmatjes E; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain., Boswell L; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain; Endocrinology and Nutrition Department, Althaia University Health Network, Manresa, Spain., Pané A; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain., Blanco-Carrasco AJ; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain., Vinagre I; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain., Mesa A; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain; Endocrinology and Nutrition Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., Claro M; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain., Ayala D; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain., Milad C; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain., Conget I; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain., Giménez M; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain., Amor AJ; Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain. Electronic address: ajamor@clinic.cat.
Jazyk: angličtina
Zdroj: Diabetes research and clinical practice [Diabetes Res Clin Pract] 2024 Aug; Vol. 214, pp. 111771. Date of Electronic Publication: 2024 Jul 04.
DOI: 10.1016/j.diabres.2024.111771
Abstrakt: Aims: Evaluate the association between cumulative tobacco consumption (CTC; packs-year) and atherosclerosis in type 1 diabetes (T1D), and study whether the inclusion of CTC in the Steno T1 Risk Engine (ST1RE) equation improves the identification of plaques.
Methods: Cross-sectional study in T1D patients without cardiovascular disease (CVD), with ≥ 1 of the following: ≥40 years-old, diabetic kidney disease, and/or T1D duration ≥ 10 years + cardiovascular risk factors.Preclinical atherosclerosis was evaluated by carotid ultrasonography.
Results: N = 584 patients were included (46.1 % women, age 48.7 ± 10.5 years, T1D duration 27.3 ± 10.8 years, 26.2 % active smokers). The overall plaque prevalence was 40.9 %. In models adjusted for age, sex, lipids, blood pressure, kidney function, statin use, microvascular complications and HbA 1c , CTC was dose-dependently associated with the number of plaques (none, 1-2, ≥3) overall and in both active and former smokers (p < 0.001). This association remained after adjusting for ST1RE (OR 1.11 [1.02-1.19]). Although the inclusion of CTC in the ST1RE did not improve plaque identification overall (p = 0.180), it did so when analyzing active smokers separately (AUC 0.738 vs. 0.768; p < 0.01).
Conclusions: In T1D patients, CTC is dose-dependently associated with atherosclerosis. Further prospective studies are needed to determine if CTC could identify T1D individuals more prone to accelerated atherosclerosis.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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