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Weight Control Slows Progression of Atherosclerosis in Type 1's

Posted: Thursday, December 27, 2007

Increasing calcium formation in the coronary arteries (CAC) is the best predictor of a coronary artery disease (CAD) event in patients with type 1 diabetes, researchers report.

New study findings suggest that control of body mass index can help slow CAC formation and retard the progression of atherosclerosis, in addition to controlling cholesterol levels, albumin excretion rate, and all other known risk factors for heart disease.

Dr. Trevor J. Orchard and colleagues from the University of Pittsburgh, Pennsylvania, identified risk factors for CAC progression and examined whether changes in these factors influenced progression to CAD in 222 adult patients with type 1 diabetes. The subjects were participants in the Pittsburgh Epidemiology of Diabetes Complications Study, a prospective investigation of childhood-onset type 1 diabetes.

The patients underwent two electron beam tomographic screenings 4 years apart. The team defined progression as an increase greater than 2.5 in the square root-transformed CAC score, according to findings published in the November 15th issue of the American Journal of Cardiology

After adjusting for duration of diabetes and baseline CAC, the authors found that BMI (odds ratio (OR) 1.13), non-high-density lipoprotein cholesterol (OR 1.01), and albumin excretion rate (OR 1.30) were associated with CAC progression in this cohort.

When the team assessed changes in risk factors, they found that an increase in BMI (OR 1.38) was the most influential modifiable risk factor associated with CAC progression.

Dr. Orchard's team explains, "Our ultimate goal is to identify the rate of progression that best predicts subsequent cardiovascular events."

"Although sufficient follow-up and events have not yet occurred to fully address this issue, a very preliminary look suggests that in our population, CAC score is the best single predictor of CAD events (OR 8.57 for CAC score 100 or greater)," they note. "Approximately 9% of our population developed this risk level during the 4-year period."

Furthermore, the investigators conclude, that to slow the progression of CAC, as well as for other health reasons, weight control is important for type 1 diabetics.

Source: Diabetes In Control: Am J Cardiol 2007;100:1543-1547.

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