Atherosclerosis and Childhood Diabetes - ACD
Background: Persons with type 1 Diabetes (T1D) have increased mortality due to cardiovascular disease (CVD). More scientific evidence is needed to justify aggressive early interventions during childhood. To address this, the ACD study was initiated in 2006.
Aims: To detect early signs of atherosclerosis, its progression and predisposing factors in childhood onset T1D compared to healthy controls.
Methods: This is a prospective study with follow-up every 5th year. Two of the most widely accepted surrogate markers of atherosclerosis, carotid intima media thickness (cIMT) and CRP are measured, as well as various biochemical markers of atherosclerosis and AGE`s, plus CVD risk factor analysis and clinical data collection. Cardiac ultrasound was performed at base-line, and ophthalmologic examination at 10-year.
Subjects: At baseline 324 persons with T1D aged 8-18 years from one health-region in Norway, were included together with 118 healthy controls. 80% participated again in the 5-year follow-up and 60% in the 10-year follow-up.
Progression: The baseline, 5- and 10-year follow up has all been completed and early stage atherosclerosis and low grade inflammation is observed despite short disease duration and intensive insulin treatment. The ophthalmologic examination performed at the 10-year follow up revealed that 32 % of the diabetic patients had diabetic retinopathy. We found that oxygen saturation in retinal arterioles and venules increased and vessel density in the macula decreased with increasing grade of nonproliferative retinopathy.
News from 2022: The project is still ongoing.