In patients with type 1 diabetes, adiposity is associated with increased risk of developing calcified coronary arteries but inversely related to severity of the condition, Pittsburgh researchers announced at the 67th Scientific Sessions of the American Diabetes Association in Chicago, Illinois.
Dr. Baqiyyah Conway presented findings from the Pittsburgh Epidemiology of Diabetes Complications Study, a 16-year prospective study of childhood-onset type 1 diabetes being conducted at the University of Pittsburgh.
The researchers are following 225 individuals with a mean age of 42 years and a mean duration of disease of 34 years.
Using electron beam tomography, Dr. Conway's team measured coronary artery calcium content (which correlates with coronary artery disease), visceral adiposity and subcutaneous adiposity. They also recorded body mass index (BMI) and waist circumference.
Divided into quartiles of adiposity, Dr. Conway and colleagues found "there was a positive relationship between the presence of coronary artery calcium, visceral adiposity and subcutaneous adiposity" in both men and women.
Among men but not women, coronary calcium content was also associated with BMI and waist circumference.
ON the other hand, among those with coronary artery calcification, its severity was inversely related to visceral and subcutaneous adiposity and BMI in women. For men, there was also an inverse relationship between coronary calcification severity and BMI, but not adiposity.
In other words, "women in the lowest quartile of subcutaneous adiposity and BMI had more coronary artery calcium than those in the second and third quartiles," Dr. Conway said. "Men in the lowest BMI quartile had more coronary artery calcium than those in the fourth. There was no association between waist circumference and degree of coronary artery calcium in either gender."
The inverse associations were evident even when other cardiovascular risk factors, such as elevated LDL cholesterol and triglycerides, were present.
"This double-edged association, which appears to be more pronounced in women, emphasizes the complex relationship between adiposity and cardiovascular risk in diabetes," Dr. Conway concluded.
