24 • Probe •Vol LXII • No. 4 • Sep–Dec 2023 Abstracts From Literature Cardiology Aortic Intima–Media Thickness in Children and Adolescents With Type 1 Diabetes Mellitus A greater aortic intima–media thickness (aIMT), a marker of subclinical atherosclerosis, can help identify individuals at risk of cardiovascular diseases (CVD). This systematic review with meta-analysis compared aIMT in youth with type 1 diabetes mellitus (T1DM) and healthy controls. A systematic search of published literature (till July 2021) was undertaken using electronic databases, such as Medline, EMBASE, Scopus, CINAHL, and AMED. Eligible studies reported the aIMT in participants aged < 20 years with T1DM and healthy controls. The meta-analysis was used to combine outcome data and presented as forest plots. Moderator analysis and meta-regression were conducted to identify study and participant characteristics associated with aIMT. Publication bias was assessed by funnel plot inspection. The meta-analysis of 9 studies (n = 1030 with T1DM and n = 498 healthy control participants) indicated, with high heterogeneity (I2, 98%), that youth with T1DM have a higher aIMT compared with healthy controls (mean difference [95% CI], 0.11 [0.04–0.18] mm, P = .003). Factors that were associated with high aIMT in T1DM compared with the controls included the use of a phased array probe versus linear array probe; a long diabetes duration; a high insulin dose; a high BMI z-score and waist circumference; and high LDL cholesterol, triglyceride, and diastolic blood pressure levels. T1DM in youth is associated with a higher aIMT compared with healthy controls. A longer duration of diabetes and major CVD risk factors were also associated with a higher aIMT. Together, these findings provide a strong rationale for targeting modifiable risk factors in CVD prevention. Source: Gow ML, et al. Pediatr Diabetes. 2022;23(4):489–498. Effect of Accumulated Hypertension Burden on Atrial Fibrillation Risk in Diabetes Mellitus Patients with diabetes mellitus are at an increased risk of incident atrial fibrillation (AF). The effect of accumulated hypertension burden is a less known modifiable risk factor. The relationship between accumulated hypertension burden and incident AF is explored in this study. The data of 526,384 patients with diabetes mellitus who underwent 3 consecutive health examinations, between 2009 and 2012, from the Korean National Health Insurance Service, were evaluated. Hypertension burden was calculated by assigning points to each stage of hypertension in each health examination: 1, for stage 1 hypertension (systolic blood pressure [SBP], 130–139 mmHg; diastolic blood pressure [DBP], 80–89 mmHg); 2, for stage 2 (SBP, 140–159 mmHg and DBP, 90–99 mmHg); and 3, for stage 3 (SBP, ≥ 160 mmHg and DBP, ≥ 100 mmHg). Patients were categorized into 10 hypertensive burden groups (0–9). Groups 1 to 9 were then clustered into 1–3, 4–6, and 7–9. Throughout the mean follow-up duration of 6.7 ± 1.7 years, AF was newly diagnosed in 18,561 (3.5%) patients. Compared with patients with hypertension burden 0, those with a burden of 1 to 9 showed a progressively increasing risk of incident AF: 6%, 11%, 16%, 24%, 28%, 41%, 46%, 57%, and 67% respectively. Clusters 1–3, 4–6, and 7–9 showed increased risks by 10%, 26%, and 45%, respectively, compared with a hypertension burden of 0. Accumulated hypertension burden was associated with an increased risk of incident AF in patients with diabetes mellitus. Strict BP control should be emphasized in these patients. Source: Choi JM, et al. Cardiovasc Diabetol. 2023;22(1):12.
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