Original Article

Association between carotid intima-media thickness, buccodental status, and glycemic control in pediatric type 1 diabetes

  1. Rita A. Gómez-Díaz1,*,
  2. Eleazar Ramírez-Soriano1,
  3. Janet Tanus Hajj2,
  4. Elia Bautista Cruz3,
  5. Cesar Jiménez Galicia3,
  6. Miguel Angel Villasis-Keever3,
  7. Carlos A. Aguilar-Salinas4,
  8. Niels H. Wacher1

Article first published online: 14 MAY 2012

DOI: 10.1111/j.1399-5448.2012.00868.x

Issue

Pediatric Diabetes

Pediatric Diabetes

Volume 13, Issue 7, pages 552–558, November 2012

Additional Information

How to Cite

Gómez-Díaz RA, Ramirez-Soriano E, Tanus-Hajj J, Bautista-Cruz E, Jiménez-Galicia C, Villasis-Keever MA, Aguilar-Salinas CA, Wacher NH. Association between carotid intima-media thickness, buccodental status, and glycemic control in pediatric type 1 diabetes.

Author Information

  1. 1

    Unidad de Investigación Médica en Epidemiología Clínica, Mexico City, Mexico

  2. 2

    Radiodiagnóstico de la UMAE Hospital de Especialidades, Mexico City, Mexico

  3. 3

    UMAE Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico

  4. 4

    Departmento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición, Mexico City, Mexico

* Corresponding author:
Rita A. Gómez Díaz MD,
Unidad de Investigación Médica en
Epidemiología Clínica,
UMAE Hospital de Especialidades,
CMN-SXXI, IMSS, Av. Cuauhtémoc
#330, Col. Doctores,
Deleg. Cuauhtémoc 06725
México, D.F., México.
Tel: (52–55)56276900x21481;
fax: (52–55)10541599;
e-mail: ritagomezdiaz@yahoo.com.mx

Publication History

  1. Issue published online: 29 OCT 2012
  2. Article first published online: 14 MAY 2012
  3. Manuscript Accepted: 6 MAR 2012
  4. Manuscript Received: 28 FEB 2012
  5. Manuscript Revised: 28 FEB 2012

Funded by

  • CONACYT. Grant Number: SALUD-2010-01-142314

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Keywords:

  • buccodental status;
  • cIMT;
  • glycemic control;
  • pediatric patients;
  • type 1 diabetes

Objective

To evaluate the association between carotid intima-media thickness, buccodental status, and glycemic control in patients with type 1 diabetes.

Methods

Cross-sectional study with consecutive cases attended in an outpatient clinic (n = 69). Medical and clinical dental history, HbA1c, lipid profile, treatment period, and daily insulin dosage were recorded. Sociodemographic data and anthropometrical measurements were obtained by standardized questionnaire. Doppler real-time ultrasound was performed by a single experienced vascular radiologist blinded to the study. Assessment of buccodental status was done by the Maxillofacial Unit of the Pediatrics Hospital, and an oral scrape culture was collected.

Results

The mean age was 11.7 ± 3.0 years, with diabetes 5.1 ± 3.3 years. Mean HbA1c was 8.5 ± 1.7%. Primary teeth were present in 52.2% and bacterial plaque in 94.2%. Buccodental conditions featured caries (63.8%), gingivitis (84%), and enamel demineralization (26.1%): white spot lesions (18.8%) and cavitated lesions (7.3%). Bacteria associated with caries were found in 44.1%. Patients in the highest HbA1c tertile (>8.5%) had greater frequency of buccodental conditions and were positive for Streptococcus mutans and Candida albicans; also, cIMT increased and vessel compliance decreased compared to those in the lowest tertile (<7.0%) (p < 0.05).

Conclusions

More buccodental conditions and carotid intima-media thickness increase appeared in the patients with HbA1c level > 8.5%, suggesting onset of atherosclerosis. The correlation between buccodental status and HbA1c values may indicate the connection between inflammatory states of atherosclerosis and type 1 diabetes.

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