Assessment of coronary artery calcification using dual-source computed tomography in adult asymptomatic patients with type 1 diabetes mellitus
Pal Maurovich-Horvat, Terez Mori, Gabor Kerecsen, Jozsef Fovenyi, Tamas Sallai, Istvan Preda, Bela Merkely, Gyorgy Jermendy
Med Sci Monit 2010; 16(7): MT59-64
Available online: 2010-06-25
Background: Experience with dual-source computed tomography (DSCT) for detecting coronary artery calcification (CAC) in patients with type 1 diabetes is limited.
Material/Methods: A non-contrast DSCT scan was acquired in 46 type 1 diabetic patients. All scans were suitable for evaluating CAC expressed in Agatston-scores (effective radiation dose 0.66 [0.59–0.81] mSv; median [interquartile range]).
Results: In 21 patients Agatston scores were ≥1 (range 1–2353), while 25 patients had no detectable calcium deposits in the coronary arteries. Patients with vs. without CAC had higher age (52 [44–59] vs. 41 [38–48] yrs; p=0.0045), longer duration of diabetes (25.3 [23.4–36.3] vs. 23.3 [15.7–30.4] yrs; p=0.0238), greater waist circumference (88 [77–98] vs. 79 [75–87] cm; p=0.0147) and BMI (26.7 [24.5–28.4] vs. 22.6 [21.7–25.6] kg/m2; p=0.0109). Moreover, patients with vs. without detectable CAC had higher serum LDL-cholesterol (3.35 [3.15–3.53] vs. 2.92 [2.62–3.33] mmol/l; p=0.0069) and serum uric acid values (236 [191–266] vs. 200 [170-219] µmol/l; p=0.0437). Hypertension was more frequent (p=0.0144) in patients with than without CAC. The 2 subgroups did not differ in long-term average HbA1c values (7.97 [7.30–8.56] vs. 8.06 [7.24–9.05]%; p=0.7491); however, estimated insulin sensitivity (estimated glucose disposal rate) was lower in patients with vs. without detectable CAC (7.43 [5.73–8.58] vs. 9.24 [8.22–10.72] mg/kg/min; p=0.0017).
Conclusions: Non-invasive detection of CAC is feasible with a low dose DSCT scan. CAC in type 1 diabetic patients is associated with cardiovascular risk factors rather than with long-term glycemic control.
Keywords: Diabetes Mellitus, Type 1 - radiography, Coronary Vessels - pathology, Coronary Angiography, Calcinosis - radiography, Adult, Tomography, X-Ray Computed - methods