Dose-Dependent association of cumulative tobacco consumption with the presence of carotid atherosclerosis in individuals with type 1 diabetes
Authors' conclusion
In T1D patients, CTC is dose-dependently associated with atherosclerosis. Further prospective studies are needed to determine if CTC could identify T1D individuals more prone to accelerated atherosclerosis.
Study context
- Population
- T1D patients without cardiovascular disease (CVD), with ≥1 of: ≥40 years old, diabetic kidney disease, and/or T1D duration ≥10 years + cardiovascular risk factors; 46.1 % women, age 48.7 ± 10.5 years, 26.2 % active smokers
- Participants
- 584 patients
- Exposure
- Cumulative tobacco consumption and carotid atherosclerosis
- Outcome
- Association of CTC with carotid atherosclerosis (number of plaques: none, 1-2, ≥3) by carotid US
Main finding
As reported in the abstract
Number of carotid plaques (none, 1-2, ≥3)
- Overall plaque prevalence
- 40.9 %
- Cumulative tobacco consumption (CTC) dose-dependently associated with number of plaques overall and in both active and former smokers (adjusted for age, sex, lipids, blood pressure, kidney function, statin use, microvascular complications and HbA1c)
- p < 0.001
- Association after adjusting for Steno T1 Risk Engine (ST1RE), OR
- 1.11 [1.02-1.19]
Observational data: associations, not effects.
Further findings
Plaque identification with CTC added to ST1RE
- No improvement overall
- P = 0.180
- Improved in active smokers, AUC
- 0.738 vs. 0.768; p < 0.01
Original publication
Dose-Dependent association of cumulative tobacco consumption with the presence of carotid atherosclerosis in individuals with type 1 diabetes. Diabetes Res Clin Pract. Published 4 July 2024. doi:10.
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