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    Arterial Wall Thickening and Stiffening in Children and Adolescents with Type 1 Diabetes
    (Elsevier Ireland Ltd, 2006) Atabek, Mehmet Emre; Kurtoğlu, Selim; Pirgon, Özgür; Baykara, Murat
    Objective: We evaluated structural and functional characteristics of the common carotid artery (CCA), a marker of early carotid atherosclerosis, and investigated their relation to metabolic and anthropometric parameters in children and adolescents with type 1 diabetes. Materials and methods: Non-invasive ultrasonographic measurements were made in 45 type I diabetic patients and 33 controls. Age, sex, and body mass index were matched between patients and controls. We investigated intima-media thickness (IMT), compliance, distensibility, diastolic wall stress (DWS) and incremental elastic modulus (IEM) of the CCA. Metabolic and anthropometric parameters such as serum lipids, plasma glycated haemoglobin, body mass index, waist-hip ratio and blood pressure were assessed. Results: The diabetic patients had significantly higher CCA-IMT than the controls (0.48 +/- 0.06 mm versus 0.33 +/- 0.07 mm; p < 0.001). The diabetic children had significantly higher values than the controls for DWS (1.18 +/- 0.29 mmHg x 102 versus 0.81 +/- 0.25 mmHg x 10(2); p < 0.001) and for IEM (1.26 +/- 0.57 mmHg x 10(3) versus 0.77 +/- 0.28 mmHg x 10(3); P < 0.001). The difference was not significant between patients and controls for arterial compliance and for distensibility (p > 0.05). In a multivariate regression model for all subjects, diabetic state was the best predictor of IMT (p < 0.001), DWS (p < 0.001) and IEM (p = 0.001). Conclusion: Our results suggested that children and adolescent patients with type I diabetes are associated with early impairment of CCA structure and function and that diabetic state may be the main risk factor for CCA wall stiffening and thickening, which are of considerable concern as possible early events in the genesis of atheroma.
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    Association Between Apolipoprotein E Polymorphism and Subclinic Atherosclerosis in Patients with Type 1 Diabetes Mellitus
    (TURKISH PEDIATRIC ENDOCRINOLOGY & DIABETES SOCIETY, 2012) Atabek, Mehmet Emre; Ozkul, Yusuf; Eklioglu, Beray Selver; Kurtoglu, Selim; Baykara, Murat
    Objective: The most important cause of morbidity and mortality in type 1 diabetes mellitus (DM) is atherosclerosis. Apolipoprotein E (Apo E) polymorphism is accused of being the genetic risk factor for atherosclerosis. The aim of the present study was to determine which Apo E polymorphism was related to atherosclerosis in patients with type 1 DM. Methods: Seventy-four patients with type 1 DM were enrolled in the study. Age, diabetes duration, daily insulin dose, microalbuminuria, and major cardiovascular risk factors including anthropometric and metabolic parameters were assessed in each patient. Non-invasive ultrasonographic measurements were also performed. For determination of Apo E genotype, DNA was extracted from venous blood from all subjects using standard methods. Apo E genotyping was performed using a PCR-restriction fragment-length polymorphism assay. Results: Systolic blood pressure and carotid artery intima-media thickness (CA-IMT) were increased in subjects with E4/E4 polymorphism. According to univariate analysis, when adjusted for all risk factors, genotypes did not differ for total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides (p>0.05). However, E3/E3, E3/E4 and E4/E4 genotypes were found to be associated with an increase in CA-IMT (p<0.001). Conclusions: Our results suggest that the polymorphism associated with atherosclerosis in type1 DM is Apo E4/E4.
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    Effectiveness of pentoxifylline on the cross-sectional area of intima media thickness and functions of the common carotid artery in adolescents with type 1 diabetes
    (WALTER DE GRUYTER & CO, 2011) Atabek, Mehmet Emre; Kurtoglu, Selim; Selver, Beray; Baykara, Murat
    Objective: The aim of the present study was to evaluate the effect of oral pentoxifylline on the cross-sectional area of intima media thickness (CSA-IMT) and functions of the common carotid artery, a marker of early atherosclerosis, in adolescents with type 1 diabetes. Patients and methods: Non-invasive ultrasonographic measurements were made in 56 type 1 diabetic patients. The diabetic patients were matched first in terms of age, diabetes duration, major cardiovascular risk factors, including anthropometric and metabolic parameters as well as ultrasonographic measurements, then one individual within each pair randomized into a pentoxifylline group and a placebo (control) group (i.e., 32 on pentoxifylline group and 24 on placebo). Pentoxifylline was administered for 6 months. We investigated the change of CSA-IMT, compliance, distensibility, diastolic wall stress (DWS), and incremental elastic modulus of the common carotid artery at 6 months after pentoxifylline. Results: In comparison of changes in common carotid artery measurements between the two groups, the pentoxifylline treatment group had significantly higher values than the controls for CSA-IMT (-2.6 +/- 0.1 vs. 0.7 +/- 0.4 mm(2), p=0.001) and for DWS (-0.38 +/- 0.02 vs. -0.05 +/- 0.05 mm Hgx10(2), p<0.001). In a multivariate regression model for all patients, being in pentoxifylline group was the best predictor of the change DWS (beta=-0.52, p<0.001). Conclusion: Our preliminary results suggest that pentoxifylline has an antiatherogenic action and might modulate risk factors for atherosclerosis in type 1 diabetes.