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Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes
OBJECTIVE: Determine the impact of islet transplantation on carotid intima-media thickness (CIMT), a marker for atherosclerosis, in type 1 diabetes without kidney disease. RESEARCH DESIGN AND METHODS: Consecutive case series of 15 adults (mean age [SD], 49 years [10 years]; 87% female) with type 1 d...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Diabetes Association
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554308/ https://www.ncbi.nlm.nih.gov/pubmed/23172970 http://dx.doi.org/10.2337/dc12-0679 |
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author | Danielson, Kirstie K. Hatipoglu, Betul Kinzer, Katie Kaplan, Bruce Martellotto, Joan Qi, Meirigeng Mele, Alessandra Benedetti, Enrico Oberholzer, José |
author_facet | Danielson, Kirstie K. Hatipoglu, Betul Kinzer, Katie Kaplan, Bruce Martellotto, Joan Qi, Meirigeng Mele, Alessandra Benedetti, Enrico Oberholzer, José |
author_sort | Danielson, Kirstie K. |
collection | PubMed |
description | OBJECTIVE: Determine the impact of islet transplantation on carotid intima-media thickness (CIMT), a marker for atherosclerosis, in type 1 diabetes without kidney disease. RESEARCH DESIGN AND METHODS: Consecutive case series of 15 adults (mean age [SD], 49 years [10 years]; 87% female) with type 1 diabetes for ≥5 years (mean duration [SD], 30 years [12 years]; mean HbA(1c) [SD], 7.2% [0.9%]), without kidney disease, presenting with severe hypoglycemic unawareness to undergo allogeneic pancreatic islet transplant(s) (one to three each) in a phase 1/2 and 3 clinical trial. Current follow-up ranges from 1 to 5 years (2005–2011). CIMT of the common and internal carotid arteries was measured before and every 12–16 months after the first transplant (two to six CIMTs each) by one ultrasonographer and one blinded reader. CIMT was analyzed as change from baseline to 12- and 50-month follow-up; a combined CIMT score was calculated as the sum of the standardized IMT scores (SD units [SDs]) of both arteries. RESULTS: All patients achieved insulin independence after one to three transplants. CIMT decreased at 12 months (n = 15) for the common carotid (−0.058 mm; P = 0.006) and combined score (−1.28 SDs; P = 0.004). In those with 50-month follow-up (n = 7), the decrease in the combined score continued from 12 (−1.59 SDs; P = 0.04) to 50 months (−0.77 SDs; P = 0.04). During follow-up, the decreasing slope of change in CIMT was associated with decreasing slopes of change in HbA(1c), lipoproteins, and cardiovascular/inflammatory markers. CONCLUSIONS: Islet transplantation may ameliorate diabetes-related atherosclerosis through improved glycemic control consequent to restoring endogenous insulin secretion, and optimal lipid management posttransplant also contributes. |
format | Online Article Text |
id | pubmed-3554308 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-35543082014-02-01 Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes Danielson, Kirstie K. Hatipoglu, Betul Kinzer, Katie Kaplan, Bruce Martellotto, Joan Qi, Meirigeng Mele, Alessandra Benedetti, Enrico Oberholzer, José Diabetes Care Original Research OBJECTIVE: Determine the impact of islet transplantation on carotid intima-media thickness (CIMT), a marker for atherosclerosis, in type 1 diabetes without kidney disease. RESEARCH DESIGN AND METHODS: Consecutive case series of 15 adults (mean age [SD], 49 years [10 years]; 87% female) with type 1 diabetes for ≥5 years (mean duration [SD], 30 years [12 years]; mean HbA(1c) [SD], 7.2% [0.9%]), without kidney disease, presenting with severe hypoglycemic unawareness to undergo allogeneic pancreatic islet transplant(s) (one to three each) in a phase 1/2 and 3 clinical trial. Current follow-up ranges from 1 to 5 years (2005–2011). CIMT of the common and internal carotid arteries was measured before and every 12–16 months after the first transplant (two to six CIMTs each) by one ultrasonographer and one blinded reader. CIMT was analyzed as change from baseline to 12- and 50-month follow-up; a combined CIMT score was calculated as the sum of the standardized IMT scores (SD units [SDs]) of both arteries. RESULTS: All patients achieved insulin independence after one to three transplants. CIMT decreased at 12 months (n = 15) for the common carotid (−0.058 mm; P = 0.006) and combined score (−1.28 SDs; P = 0.004). In those with 50-month follow-up (n = 7), the decrease in the combined score continued from 12 (−1.59 SDs; P = 0.04) to 50 months (−0.77 SDs; P = 0.04). During follow-up, the decreasing slope of change in CIMT was associated with decreasing slopes of change in HbA(1c), lipoproteins, and cardiovascular/inflammatory markers. CONCLUSIONS: Islet transplantation may ameliorate diabetes-related atherosclerosis through improved glycemic control consequent to restoring endogenous insulin secretion, and optimal lipid management posttransplant also contributes. American Diabetes Association 2013-02 2013-01-17 /pmc/articles/PMC3554308/ /pubmed/23172970 http://dx.doi.org/10.2337/dc12-0679 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Original Research Danielson, Kirstie K. Hatipoglu, Betul Kinzer, Katie Kaplan, Bruce Martellotto, Joan Qi, Meirigeng Mele, Alessandra Benedetti, Enrico Oberholzer, José Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes |
title | Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes |
title_full | Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes |
title_fullStr | Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes |
title_full_unstemmed | Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes |
title_short | Reduction in Carotid Intima-Media Thickness After Pancreatic Islet Transplantation in Patients With Type 1 Diabetes |
title_sort | reduction in carotid intima-media thickness after pancreatic islet transplantation in patients with type 1 diabetes |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3554308/ https://www.ncbi.nlm.nih.gov/pubmed/23172970 http://dx.doi.org/10.2337/dc12-0679 |
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