Coronary Calcification in Long-term Type 1 Diabetic Patients - A Study with Multi Slice Spiral Computed Tomography

C. Thilo; E. Standl; A. Knez; M. Reiser; G. Steinbeck; R. Haberl; O. Schnell

doi:10.1055/s-2004-830418

Experimental and Clinical Endocrinology & Diabetes, Inhaltsverzeichnis

Exp Clin Endocrinol Diabetes 2004; 112(10): 561-565
DOI: 10.1055/s-2004-830418

Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Coronary Calcification in Long-term Type 1 Diabetic Patients - A Study with Multi Slice Spiral Computed Tomography

C. Thilo¹ , E. Standl² , A. Knez¹ , M. Reiser⁴ , G. Steinbeck¹ , R. Haberl³ , O. Schnell²

¹Klinikum der Universität München - Medical Hospital I, Großhadern, Munich, Germany
²Diabetes Research Institute, Munich, Germany
³Krankenhaus Pasing, Munich, Germany
⁴Institute for Radiology, Ludwig-Maximilians-Universität, Munich, Germany

Abstract

The risk for cardiovascular disease in diabetes is excessive. Multislice spiral computed tomography (MSCT) is a new technique for the assessment of coronary calcification in coronary artery disease. The aim of the study was to evaluate the presence of coronary calcium in asymptomatic long-term type 1 diabetic patients. Seventy-one type 1 diabetic patients (age 48 ± 9 y, HbA1c 7.7 ± 1.2, BMI 24.4 ± 2.8, duration of diabetes 26 ± 9 y) without clinical evidence for coronary artery disease were assessed with MSCT. A volumetric score was used to calculate the coronary calcification (CC) score. Five cardiac reflex tests were performed to study patients for cardiac autonomic neuropathy. Coronary calcifications were detectable in 22 (31 %) type 1 diabetic patients (CC-score > 0, mean CC-score 174 ± 228 [X±SD]). Fourty-nine (69 %) type 1 diabetic patients demonstrated no coronary calcifications (CC-score= 0). In patients with coronary calcifications, both cardiac autonomic neuropathy and retinopathy were detected more frequently than in those without (64 % vs. 29 %, p < 0.02; 59 % vs. 31 %; p < 0.02). Duration of diabetes was longer in patients with than without coronary calcification (32 ± 10 y vs. 24 ± 8 y, p < 0.01). Age, BMI, and HbA1c were not significantly different between patients with and without coronary calcification. The study demonstrates that nearly one third of asymptomatic long-term type 1 diabetic patients present with coronary calcifications. In the patients, there is evidence for an association between coronary calcification and both cardiac autonomic neuropathy and retinopathy. MSCT is a promising non-invasive approach to analyze early alterations of the coronary system in diabetic patients.

Key words

heart - diabetes - calcium - coronary syndrome - ct

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M. D. O. Schnell

Diabetes Research Institute Munich

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80804 München

Germany

Telefon: + 49(0)8938380700

Fax: + 49 (0) 89 38 38 07 01

eMail: oliver.schnell@lrz.uni-muenchen.de