Arterial Stiffness Is Highly Correlated With The Scores Obtained From The Steno Type 1 Risk Engine In Subjects With T1dm

ObjectivesCurrently used risk scores for type 2 diabetes mellitus (T2DM) clearly underestimate cardiovascular risk in type 1 diabetes (T1DM). Hence, there is a need to develop novel and specific risk-estimation tools for this population. We aimed to assess the relationship between the Steno Type 1 Risk Engine (ST1RE) and arterial stiffness (AS), and to identify potential cutoff points of interest in clinical practice.Design and methodsA total of 179 patients with T1DM (50.8% men, mean age 41.2 +/- 13.1 years), without established cardiovascular disease, were evaluated for clinical and anthropometric data (including classical cardiovascular risk factors), and AS measured by aortic pulse-wave velocity (aPWV). The ST1RE was used to estimate 10-year cardiovascular risk and patients were classified into 3 groups: low-(<10%; n = 105), moderate-(10-20%; n = 53) and high-risk (>= 20%; n = 21).ResultsWhen compared with the low-and moderate-risk groups, patients in the high-risk group were older, had higher prevalence of hypertension, dyslipidemia and insulin-resistance, and had higher body-mass index and HbA1c. aPWV increased in parallel with estimated cardiovascular risk (6.4 +/- 1.0, 8.4 +/- 1.3 and 10.3 +/- 2.6m/s; p<0.001). As an evaluation of model performance, the C-statistic of aPWV was 0.914 (95% confidence interval [CI]: 0.873-0.950) for predicting moderate/high-risk and 0.879 (95% CI: 0.809-0.948) for high-risk, according to the ST1RE. The best cut-off points of aPWV were 7.3m/s (sensitivity: 86%, specificity: 83%) and 8.7m/s (sensitivity: 76%, specificity: 86%) for moderate/high- and high-risk, respectively.ConclusionsAS is highly correlated with the scores obtained from the ST1RE. We have identified two cut-off points of AS that can clearly discriminate moderate/high-and high-risk T1DM patients, which could be of great value in clinical practice.