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Article ; Online: Changes in physical activity habits in subjects with type 1 diabetes: A comparative study 10 years apart.

Brugnara, Laura / Hernandez, Alba / Amor, Antonio J / Roca, Daria / Gimenez, Marga / Segui, Núria / Conget, Ignacio / Esmatjes, Enric

Endocrinologia, diabetes y nutricion

2023 Volume 70, Issue 5, Page(s) 319–325

Abstract: Introduction: Physical activity (PA) is highly recommended in type 1 diabetes (T1D). Few studies have reported the amount of PA performed by individuals with T1D in their daily life, and there is no information about changes over time.: Material and ... ...

Abstract	Introduction: Physical activity (PA) is highly recommended in type 1 diabetes (T1D). Few studies have reported the amount of PA performed by individuals with T1D in their daily life, and there is no information about changes over time. Material and methods: Cross-sectional study in patients with T1D from a referral hospital recruited in two different periods: data from the Biobank registers from 2009 and data from patients attending visits at the hospital in 2019, on a consecutive basis. Data included clinical characteristics and the PA assessment through the International Physical Activity Questionnaire-short form (IPAQ-SF). Results: In 2019, participants with T1D (n=135) reported a lower sedentary lifestyle and greater levels of high PA compared to subjects with T1D (n=355) from 10 years earlier (6.7% vs. 14.1% sedentariness, p=0.015; and 52.6% vs. 25.4% of high PA, p<0.001, respectively). Similar results were identified when the groups were divided according to sex. Both groups presented similar distribution by sex (women, 54% vs. 55%), age (40 vs. 39 years old), years with diabetes (20 vs. 18 years), BMI (25 vs. 24kg/m Conclusions: The findings indicate that PA has significantly increased in subjects with T1D over the last 10 years. Future studies are needed to assess whether these healthier habits translate into better outcomes in this high-risk population.
MeSH term(s)	Humans ; Female ; Adult ; Diabetes Mellitus, Type 1 ; Cross-Sectional Studies ; Exercise ; Risk Factors ; Sedentary Behavior
Language	English
Publishing date	2023-06-01
Publishing country	Spain
Document type	Journal Article
ISSN	2530-0180
ISSN (online)	2530-0180
DOI	10.1016/j.endien.2023.05.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Severe hypoglycemia and hypoglycemia awareness are associated with preclinical atherosclerosis in patients with type 1 diabetes without an estimated high cardiovascular risk.

Mesa, Alex / Giménez, Marga / Perea, Verónica / Serés-Noriega, Tonet / Boswell, Laura / Blanco, Jesús / Milad, Camila / Pané, Adriana / Esmatjes, Enric / Vinagre, Irene / Conget, Ignacio / Viñals, Clara / Amor, Antonio J

Diabetes/metabolism research and reviews

2024 Volume 40, Issue 3, Page(s) e3785

Abstract: Aims: To explore the relationship between severe hypoglycemia (SH) and hypoglycemia awareness with preclinical atherosclerosis in type 1 diabetes (T1D).: Materials and methods: Cross-sectional study in patients with T1D without cardiovascular disease ...

Abstract	Aims: To explore the relationship between severe hypoglycemia (SH) and hypoglycemia awareness with preclinical atherosclerosis in type 1 diabetes (T1D). Materials and methods: Cross-sectional study in patients with T1D without cardiovascular disease (CVD), and with ≥1 of the following: ≥40 years, diabetic kidney disease, or ≥10 years of T1D duration with another risk factor. CVD risk was estimated with the Steno T1 Risk Engine (Steno-Risk). Carotid plaque was evaluated using standardised ultrasonography protocol. Logistic regression models adjusted for CVD risk factors were constructed to test the independent associations with SH or hypoglycemia awareness assessed by the Clarke questionnaire (Clarke). The inclusion of SH and Clarke in Steno-Risk was further evaluated. Results: We included 634 patients (52.4% men, age 48.3 ± 10.8 years, T1D duration 27.4 ± 11.1 years, 39.9% harbouring plaque). A stepped increase in the presence of plaque according to Steno-Risk was observed (13.5%, 37.7%, and 68.7%, for low, moderate, and high risk, respectively; p < 0.001). SH history (OR 4.4 [1.3-14.6]) and Clarke score (OR 1.7 [1.2-2.2]) were associated with plaque in low-risk patients (n = 192). Clarke score was also associated with plaque burden in low-moderate-risk participants (n = 436; ≥2 plaques: OR 1.2 [1.0-1.5], p = 0.031; ≥3 plaques: OR 1.4 [1.1-2.0], p = 0.025). The inclusion of SH and Clarke scores in Steno-Risk significantly improved the identification of low-risk individuals with atherosclerosis (area under the curve: 0.658 vs. 0.576; p = 0.036). Conclusions: In patients with T1D without an estimated high CVD risk, SH and hypoglycemia awareness assessment score were independently associated with preclinical atherosclerosis and improved identification of patients who would benefit from an intensive approach.
MeSH term(s)	Male ; Humans ; Adult ; Middle Aged ; Female ; Diabetes Mellitus, Type 1/complications ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cross-Sectional Studies ; Risk Factors ; Atherosclerosis/diagnosis ; Atherosclerosis/etiology ; Heart Disease Risk Factors ; Hypoglycemia
Language	English
Publishing date	2024-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1470192-3
ISSN	1520-7560 ; 1520-7552
ISSN (online)	1520-7560
ISSN	1520-7552
DOI	10.1002/dmrr.3785
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Article ; Online: Adherence to an energy-restricted Mediterranean diet is associated with the presence and burden of carotid atherosclerosis in people with type 1 diabetes.

Serés-Noriega, Tonet / Viñals, Clara / Perea, Verónica / Mesa, Alex / Boswell, Laura / Mariaca, Karla / Blanco, Jesús / Vinagre, Irene / Pané, Adriana / Milad, Camila / Solà, Clara / Esmatjes, Enric / Conget, Ignacio / Giménez, Marga / Amor, Antonio J

Diabetes/metabolism research and reviews

2024 Volume 40, Issue 3, Page(s) e3783

Abstract: Aims: People with type 1 diabetes (T1D) have an increased risk of cardiovascular disease (CVD). The Mediterranean diet is associated with reduced CVD; however, the evidence in T1D is scarce. We aimed to analyse the relationships between adherence to the ...

Abstract	Aims: People with type 1 diabetes (T1D) have an increased risk of cardiovascular disease (CVD). The Mediterranean diet is associated with reduced CVD; however, the evidence in T1D is scarce. We aimed to analyse the relationships between adherence to the energy-restricted Mediterranean diet (erMEDd) and carotid atherosclerosis. Materials and methods: We included children with T1D without CVD, with ≥1 of the following: age ≥40 years, diabetic kidney disease, or ≥10 years of disease duration with another risk factor. Plaque presence (intima-media thickness ≥1.5 mm) was determined by ultrasonography. The PREDIMED-Plus 17-item questionnaire (PP-17) was used to assess adherence to the erMEDd. Results: Four hundred one individuals were included (48% males, age 48.3 ± 11 years, diabetes duration 26.8 ± 11.4 years). Those harbouring plaques (42%) showed lower adherence to the erMEDd (PP-17: 8.9 ± 2.3 of a maximum of 17 vs. 9.8 ± 2.5, p < 0.001). Greater adherence to the erMEDd was correlated with an overall better metabolic profile. After adjusting for multiple confounders, adherence to the erMEDd was independently associated with carotid atherosclerosis (OR 0.86 [0.77-0.95] for plaque presence and OR 0.85 [0.75-0.97] for ≥2 plaques). The consumption of fruit and nuts and preference of white over red meat was higher in individuals without atherosclerosis (p < 0.05). Fruit and nut consumption was associated with lower plaque prevalence in the fully adjusted models (OR 0.38 [0.19-0.73] and 0.51 [0.29-0.93]). Conclusions: Greater adherence to the erMEDd is associated with less carotid atherosclerosis in children with T1D at high risk of CVD. Strategies to improve and implement healthy dietary patterns in this population should be encouraged.
MeSH term(s)	Male ; Child ; Humans ; Adult ; Middle Aged ; Female ; Diet, Mediterranean ; Diabetes Mellitus, Type 1/complications ; Carotid Intima-Media Thickness ; Carotid Artery Diseases/epidemiology ; Carotid Artery Diseases/etiology ; Plaque, Atherosclerotic/epidemiology ; Plaque, Atherosclerotic/etiology ; Risk Factors
Language	English
Publishing date	2024-02-16
Publishing country	England
Document type	Journal Article
ZDB-ID	1470192-3
ISSN	1520-7560 ; 1520-7552
ISSN (online)	1520-7560
ISSN	1520-7552
DOI	10.1002/dmrr.3783
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Zs.A 2119: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article: Nuclear Magnetic Resonance-Based Lipidomics in the Assessment of Cardiometabolic Risk in Type 1 Diabetes: An Exploratory Analysis.

Serés-Noriega, Tonet / Ortega, Emilio / Perea, Verónica / Giménez, Marga / Boswell, Laura / Mariaca, Karla / Font, Carla / Mesa, Alex / Viñals, Clara / Blanco, Jesús / Vinagre, Irene / Pané, Adriana / Esmatjes, Enric / Conget, Ignacio / Amor, Antonio J

Diabetes therapy : research, treatment and education of diabetes and related disorders

2023 Volume 14, Issue 3, Page(s) 553–567

Abstract: Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in type 1 diabetes (T1D). However, there is a need for daily practice tools for identifying those more prone to suffer from these events. We aimed to assess the relationships ... ...

Abstract	Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in type 1 diabetes (T1D). However, there is a need for daily practice tools for identifying those more prone to suffer from these events. We aimed to assess the relationships between nuclear magnetic resonance ( Methods: We included patients with T1D without CVD, with at least one of the following: age ≥ 40 years, diabetic kidney disease, or ≥ 10 years of evolution with another risk factor. The presence of plaque (intima-media thickness > 1.5 mm) was determined by standardized ultrasonography protocol. Lipidomic analysis was performed by Results: We included n = 131 participants (49.6% female, age 46.4 ± 10.3 years, diabetes duration 27.0 ± 9.5 years, 47.3% on statins). Carotid plaques were present in 28.2% of the individuals (n = 12, with ≥ 3 plaques). Glucose (HbA1c), anthropometric (body mass index and waist circumference), and insulin resistance-related (fatty liver index and estimated glucose disposal rate) variables were those most associated with Conclusion: In our preliminary study of individuals with T1D at high risk, several
Language	English
Publishing date	2023-02-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2566702-6
ISSN	1869-6961 ; 1869-6953
ISSN (online)	1869-6961
ISSN	1869-6953
DOI	10.1007/s13300-023-01372-x
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Article ; Online: Advanced lipoprotein profile identifies atherosclerosis better than conventional lipids in type 1 diabetes at high cardiovascular risk.

Serés-Noriega, Tonet / Ortega, Emilio / Giménez, Marga / Perea, Verónica / Boswell, Laura / Mariaca, Karla / Font, Carla / Mesa, Alex / Viñals, Clara / Blanco, Jesús / Vinagre, Irene / Pané, Adriana / Esmatjes, Enric / Conget, Ignacio / Amor, Antonio J

Nutrition, metabolism, and cardiovascular diseases : NMCD

2023 Volume 33, Issue 6, Page(s) 1235–1244

Abstract: Background and aims: People with type 1 diabetes (T1D) present lipoprotein disturbances that could contribute to their increased cardiovascular disease (CVD) risk. We evaluated the relationship between lipoprotein alterations and atherosclerosis in ... ...

Abstract	Background and aims: People with type 1 diabetes (T1D) present lipoprotein disturbances that could contribute to their increased cardiovascular disease (CVD) risk. We evaluated the relationship between lipoprotein alterations and atherosclerosis in patients with T1D. Methods and results: Cross-sectional study in subjects with T1D, without previous CVD, but high-risk (≥40 years, nephropathy, or ≥10 years of evolution of diabetes with another risk factor). The presence of plaque (intima-media thickness ≥1.5 mm) in the different carotid segments was determined by ultrasound. The advanced lipoprotein profile was analysed by magnetic resonance imaging ( Conclusions: In adults with T1D at high-risk, variables related to HDL, LDL and total atherogenic particle number are independently associated with preclinical atherosclerosis. Advanced lipoprotein profiling could be used to identify those at the highest risk of CVD.
MeSH term(s)	Adult ; Humans ; Female ; Male ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/diagnosis ; Diabetes Mellitus, Type 1/epidemiology ; Cardiovascular Diseases/diagnostic imaging ; Cardiovascular Diseases/epidemiology ; Carotid Intima-Media Thickness ; Cross-Sectional Studies ; Risk Factors ; Lipoproteins ; Atherosclerosis/diagnostic imaging ; Atherosclerosis/epidemiology ; Plaque, Atherosclerotic ; Cholesterol ; Cholesterol, LDL ; Cholesterol, HDL ; Heart Disease Risk Factors
Chemical Substances	Lipoproteins ; Cholesterol (97C5T2UQ7J) ; Cholesterol, LDL ; Cholesterol, HDL
Language	English
Publishing date	2023-04-05
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1067704-5
ISSN	1590-3729 ; 0939-4753
ISSN (online)	1590-3729
ISSN	0939-4753
DOI	10.1016/j.numecd.2023.03.025
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Zs.A 3149: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Impact of preeclampsia and parity on sex-based discrepancies in subclinical carotid atherosclerosis in type 1 diabetes.

Perea, Verónica / Vinagre, Irene / Serés-Noriega, Tonet / Viñals, Clara / Mesa, Alex / Pané, Adriana / Milad, Camila / Esmatjes, Enric / Conget, Ignacio / Giménez, Marga / Amor, Antonio J

The Journal of clinical endocrinology and metabolism

2023

Abstract: Context: The excess risk of fatal and non-fatal cardiovascular events is roughly twice as high in women than in men with type 1 diabetes (T1D).: Objective: To evaluate the impact of preeclampsia and parity on sex-based discrepancies in preclinical ... ...

Abstract	Context: The excess risk of fatal and non-fatal cardiovascular events is roughly twice as high in women than in men with type 1 diabetes (T1D). Objective: To evaluate the impact of preeclampsia and parity on sex-based discrepancies in preclinical atherosclerosis and on the diagnostic performance of a cardiovascular risk scale. Design: Cross-sectional study. Setting: Single tertiary hospital. Patients: 728 T1D (48.5% women) without cardiovascular disease and age ≥40 years, nephropathy, and/or ≥10 years of diabetes duration with another risk factor. Intervention: Standardized carotid ultrasonography. Main outcome measures: Carotid plaque determined by ultrasonography and cardiovascular risk estimated according to the Steno T1 Risk Engine (Steno-Risk). Results: Nulliparous women and parous women without previous preeclampsia had a lower risk for carotid plaque than men (adjusted odds ratio [OR]: 0.48, 95% confidence interval [0.28-0.82]; adjusted OR: 0.51 [0.33-0.79], respectively), without differences in the preeclampsia group. The prevalence of carotid plaque increased as the estimated cardiovascular risk increased in all subgroups except for preeclampsia group. The area under the curve (AUC) of the Steno-Risk for identifying ≥2 carotid plaques was lower in the preeclampsia group (men: 0.7886, nulliparous women: 0.9026, women without preeclampsia: 0.8230, preeclampsia group: 0.7841; p between groups=0.042). Neither the addition of parity nor preeclampsia in the Steno-Risk led to a statistically significant increase in the AUC. Conclusions: The risk for carotid plaque in women compared to men decreased as exposure to obstetric factors diminished. However, the addition of these factors did not improve the prediction of the Steno-Risk.
Language	English
Publishing date	2023-12-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgad755
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Uh III Zs.134: Show issues

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Article ; Online: Neutrophil-to-lymphocyte ratio is independently associated with carotid atherosclerosis burden in individuals with type 1 diabetes.

Mariaca, Karla / Serés-Noriega, Tonet / Viñals, Clara / Perea, Verónica / Conget, Ignacio / Mesa, Alex / Boswell, Laura / Font, Carla / Pané, Adriana / Vinagre, Irene / Blanco, Jesús / Esmatjes, Enric / Giménez, Marga / Amor, Antonio J

Nutrition, metabolism, and cardiovascular diseases : NMCD

2023 Volume 34, Issue 2, Page(s) 395–403

Abstract: Background and aims: Recent studies have identified a relationship between innate versus. Adaptative immunity and cardiovascular disease (CVD) in the general population, but information on type 1 diabetes (T1D) is lacking. We aimed to study the ... ...

Abstract	Background and aims: Recent studies have identified a relationship between innate versus. Adaptative immunity and cardiovascular disease (CVD) in the general population, but information on type 1 diabetes (T1D) is lacking. We aimed to study the relationship between inflammatory biomarkers and preclinical atherosclerosis in this population. Methods and results: Cross-sectional study in T1D individuals without CVD and with ≥1 of the following: ≥40 years, diabetic kidney disease, or ≥10 years of diabetes duration with classical CVD risk factors. Carotid plaques were evaluated by ultrasonography. C-reactive protein, total leukocyte count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio and systemic immune-inflammation index were assessed as inflammatory markers. Multivariate-adjusted models including age, sex, and other CVD risk factors were constructed to test their independent associations with atherosclerosis burden. We included 602 subjects (52.8% men, 48.7 ± 10.2 years old and 27.0 ± 10.5 years of diabetes duration). Carotid plaques were found in 41.2% of the individuals (12.8%, ≥3 plaques). The number of carotid plaques (none, 1-2, ≥3 plaques), was directly associated with the leukocyte count (6570 [5445-8050], 6640 [5450-8470] and 7310 [5715-8935] per mm Conclusions: The NLR was independently and directly associated with carotid plaque burden in T1D individuals. Our data support the role of innate versus. Adaptative immunity in atherosclerosis also among the T1D population.
MeSH term(s)	Male ; Humans ; Adult ; Middle Aged ; Female ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/diagnosis ; Neutrophils ; Cross-Sectional Studies ; Carotid Artery Diseases/epidemiology ; Atherosclerosis ; Plaque, Atherosclerotic ; Lymphocytes
Language	English
Publishing date	2023-09-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1067704-5
ISSN	1590-3729 ; 0939-4753
ISSN (online)	1590-3729
ISSN	0939-4753
DOI	10.1016/j.numecd.2023.09.017
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 3149: Show issues

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Article ; Online: Advanced lipoprotein profile identifies atherosclerosis better than conventional lipids in type 1 diabetes at high cardiovascular risk

Serés-Noriega, Tonet / Ortega, Emilio / Giménez, Marga / Perea, Verónica / Boswell, Laura / Mariaca, Karla / Font, Carla / Mesa, Alex / Viñals, Clara / Blanco, Jesus / Vinagre, Irene / Pané, Adriana / Esmatjes, Enric / Conget, Ignacio / Amor, Antonio J.

The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University Nutrition, Metabolism and Cardiovascular Diseases. 2023 Apr. 05,

2023

Abstract: People with type 1 diabetes (T1D) present lipoprotein disturbances that could contribute to their increased cardiovascular disease (CVD) risk. We evaluated the relationship between lipoprotein alterations and atherosclerosis in patients with T1D. Cross- ... ...

Abstract	People with type 1 diabetes (T1D) present lipoprotein disturbances that could contribute to their increased cardiovascular disease (CVD) risk. We evaluated the relationship between lipoprotein alterations and atherosclerosis in patients with T1D. Cross-sectional study in subjects with T1D, without previous CVD, but high-risk (≥40 years, nephropathy, or ≥10 years of evolution of diabetes with another risk factor). The presence of plaque (intima-media thickness ≥1.5 mm) in the different carotid segments was determined by ultrasound. The advanced lipoprotein profile was analysed by magnetic resonance imaging (¹H NMR). We included 189 patients (42% women, 47.8 ± 10.7 years, duration of diabetes 27.3 ± 10.1 years, HbA1c 7.5% [7–8]). Those with carotid plaques (35%) were older, with longer diabetes duration, had a higher prevalence of hypertension, and showed lower and smaller LDL particles (LDL-P) and HDL particles (HDL-P), but higher VLDL particles (VLDL-P). Some LDL, HDL and VLDL-related parameters were associated with atherosclerosis in sex, age and statin use adjusted models (p < 0.05), but after adjusting for multiple confounders, including conventional lipid parameters, only HDL-P (OR 0.440 [0.204–0.951]; p = 0.037), medium HDL-P (OR 0.754 [0.590–0.963]; p = 0.024), HDL-P cholesterol content (OR 0.692 [0.495–0.968]; p = 0.032), ¹H NMR LDL-P number/conventional LDL-cholesterol (OR 1.144 [1.026–1.275]; p = 0.015), and ¹H NMR non-HDL particle number/conventional non-HDL-cholesterol ratios (OR 1.178 [1.019–1.361], p = 0.026) remained associated with atherosclerosis. In adults with T1D at high-risk, variables related to HDL, LDL and total atherogenic particle number are independently associated with preclinical atherosclerosis. Advanced lipoprotein profiling could be used to identify those at the highest risk of CVD.
Keywords	atherosclerosis ; cross-sectional studies ; evolution ; hypertension ; insulin-dependent diabetes mellitus ; kidney diseases ; low density lipoprotein cholesterol ; magnetism ; metabolism ; nutrition ; risk factors ; ultrasonics ; Type 1 diabetes ; Cardiovascular risk ; Ultrasound ; Lipoprotein subclasses ; Advanced lipoprotein ; Nuclear magnetic resonance ; LDL particles
Language	English
Dates of publication	2023-0405
Publishing place	Elsevier B.V.
Document type	Article ; Online
Note	Pre-press version
ZDB-ID	1067704-5
ISSN	0939-4753
ISSN	0939-4753
DOI	10.1016/j.numecd.2023.03.025
Database	NAL-Catalogue (AGRICOLA)

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Zs.A 3149: Show issues

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Article: Midnight Cortisol is Associated with Changes in Systolic Blood Pressure and Diabetic Neuropathy in Subjects with Type 1 Diabetes Undergoing Simultaneous Kidney-Pancreas Transplantation.

Boswell, Laura / Amor, Antonio J / Montagud-Marrahi, Enrique / Casals, Gregori / Díaz-Catalan, Daniela / Banon-Maneus, Elisenda / Ramírez-Bajo, María José / Hierro, Natalia / Diekmann, Fritz / Musquera, Mireia / Serés-Noriega, Tonet / Esmatjes, Enric / Ferrer-Fàbrega, Joana / Ventura-Aguiar, Pedro / Hanzu, Felicia A

Diabetes therapy : research, treatment and education of diabetes and related disorders

2023 Volume 15, Issue 1, Page(s) 165–181

Abstract: Introduction: An increased midnight cortisol (MC) has been described in end-stage kidney disease (ESKD) and type 1 diabetes (T1D). Lower circulating levels of the cytokine soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) have ... ...

Abstract	Introduction: An increased midnight cortisol (MC) has been described in end-stage kidney disease (ESKD) and type 1 diabetes (T1D). Lower circulating levels of the cytokine soluble tumor necrosis factor (TNF)-like weak inducer of apoptosis (sTWEAK) have been found in T1D and ESKD and associated with cardiovascular (CV) events in the latter. We aimed to study MC and sTWEAK in simultaneous pancreas-kidney transplant (SPKT) recipients, and the association of these markers with CV risk factors and transplant outcomes. Methods: This was a retrospective cohort study including subjects with T1D who received a first SPKT between 2008 and 2020. MC and sTWEAK at baseline were correlated with CV risk factors and evolution 1 year after SPKT. Results: We included 29 subjects (58.6% women, mean age 43.5 ± 7.5 years, diabetes duration 31.9 ± 9.4 years). Systolic blood pressure (SBP) increased directly with MC quartiles, despite similar hypertension prevalence (p < 0.05). At 1 year, antihypertensive treatment was deintensified in those in lower MC quartiles (p < 0.05). Diabetic neuropathy prevalence decreased progressively in higher cortisol quartiles (p for trend = 0.005). Low MC was associated with delayed kidney graft function (p for trend = 0.044), and high sTWEAK with kidney graft rejection (p for trend = 0.018). In multivariate analyses, MC (standardized-β 0.505, p = 0.004) and age (standardized-β - 0.460, p = 0.040) were independently correlated with SBP, and MC was independently associated with the presence of diabetic neuropathy (OR 0.633, 95% CI 0.425-0.944, p = 0.025), adjusted for confounders. Conclusions: In this exploratory study, lower MC was associated with a lower baseline SBP, an improvement of antihypertensive treatment 1 year after transplant, and a higher diabetic neuropathy prevalence in SPKT recipients.
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2566702-6
ISSN	1869-6961 ; 1869-6953
ISSN (online)	1869-6961
ISSN	1869-6953
DOI	10.1007/s13300-023-01487-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Use of the Steno T1 Risk Engine Identifies Preclinical Atherosclerosis Better Than Use of ESC/EASD-2019 in Adult Subjects With Type 1 Diabetes at High Risk.

Serés-Noriega, Tonet / Giménez, Marga / Perea, Verónica / Boswell, Laura / Viñals, Clara / Blanco, Jesús / Vinagre, Irene / Pané, Adriana / Esmatjes, Enric / Conget, Ignacio / Amor, Antonio J

Diabetes care

2022 Volume 45, Issue 10, Page(s) 2412–2421

Abstract: Objective: To evaluate the concordance between the 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD (ESC/EASD-2019) and the Steno T1 Risk Engine (Steno-Risk) cardiovascular risk scales ... ...

Abstract	Objective: To evaluate the concordance between the 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD (ESC/EASD-2019) and the Steno T1 Risk Engine (Steno-Risk) cardiovascular risk scales for individuals with type 1 diabetes (T1D) without cardiovascular disease (CVD) and to analyze the relationships of their use with identification of preclinical atherosclerosis. Research design and methods: We consecutively selected patients with T1D, without CVD, age ≥40 years, with nephropathy, and/or with ≥10 years of T1D evolution with another risk factor. The presence of plaque at different carotid segments was determined by ultrasonography. Cardiovascular risk was estimated in accord with ESC/EASD-2019 risk groups (moderate/high/very high) and the Steno-Risk (<10%, low; 10-20%, moderate; ≥20%, high), as T1D-specific scores. In an exploratory analysis, we also evaluated the non-T1D-specific 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk (ACC/AHA-2013) pooled cohort equation for individuals between 40 and 79 years of age. Results: We included 501 patients (53% men, mean age 48.8 years, median T1D duration 26.5 years, 41.3% harboring plaques). Concordance between T1D-specific scales was poor (κ = 0.19). A stepped increase in the presence of plaques according to Steno-Risk category was seen (18.4%, 38.2%, and 64.1%, for low, moderate, and high risk, respectively; P for trend <0.001), with no differences according to ESC/EASD-2019 (P = 0.130). Steno-Risk identified individuals with plaques, unlike ESC/EASD-2019 (area under the curve [AUC] 0.691, P < 0.001, vs. AUC 0.538, P = 0.149). Finally, in polynomial regression models (with adjustment for lipid parameters and cardioprotective treatment), irrespective of the ESC/EASD-2019 category, high risk by Steno-Risk was directly associated with atherosclerosis (in moderate/high-risk by ESC/EASD-2019 odds ratio 2.91 [95% CI 1.27-6.72] and 4.94 [2.35-10.40] for the presence of plaque and two or more plaques). Similar results were obtained with discordant higher Steno-Risk versus ACC/AHA-2013 (P < 0.001). Conclusions: Among T1D patients undergoing primary prevention, use of Steno-Risk seems to result in better recognition of individuals with atherosclerosis in comparison with ESC/EASD-2019. Notwithstanding, carotid ultrasound could improve the categorization of cardiovascular risk.
MeSH term(s)	Adult ; Atherosclerosis/drug therapy ; Cardiovascular Diseases/prevention & control ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/drug therapy ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Lipids ; Male ; Middle Aged ; Risk Assessment ; Risk Factors
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipids
Language	English
Publishing date	2022-08-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	441231-x
ISSN	1935-5548 ; 0149-5992
ISSN (online)	1935-5548
ISSN	0149-5992
DOI	10.2337/dc22-0118
Database	MEDical Literature Analysis and Retrieval System OnLINE

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