Pre-eclampsia linked to preclinical atherosclerosis in T1D women

Previous pre-eclampsia (PE) is associated with increased preclinical carotid atherosclerosis in women with type 1 diabetes (T1D), reports a study.

One hundred twelve women without cardiovascular (CV) disease and who had their last pregnancy ≥5 years before were enrolled and categorized as follows: (1) T1D and previous PE (T1D⁺/PE⁺; n=28); (2) T1D without PE (T1D⁺/PE^–; n=28); (3) previous PE without T1D (T1D^–/PE⁺; n=28); and (4) controls (without T1D or PE; T1D^–/PE^–; n=28).

The authors matched the groups by age, several CV risk factors, and diabetes duration and retinopathy (in women with T1D). Standardized ultrasonography protocol was used to assess carotid intima-media thickness (IMT) and the presence of plaque (IMT ≥1.5 mm).

Of the participants (mean age, 44.9±7.8 years), 21.4 percent were active smokers and 14.3 percent had hypertension). Women in T1D groups (T1D⁺/PE⁺ and T1D⁺/PE^–) were more likely to present with hypertension (23.2 percent vs 5.4 percent; p<0.01) and be on statin treatment (37.5 percent vs 8.9; p<0.01), without differences in other CV risk factors. About a fifth (20.5 percent) of the participants had carotid plaques.

Multivariate models adjusted for age, statins and CV risk factors showed a similar impact of both T1D (odds ratio [OR], 5.45, 95 percent confidence interval [CI], 1.36–21.9) and PE (OR, 4.24, 95 percent CI, 1.04–17.3) on the presence of plaque.

An additive effect was observed when T1D and PE were combined, both in common carotid-IMT (T1D⁺/PE^– or T1D^–/PE⁺: β, 0.198; T1D⁺/PE⁺: β, 0.297) and in the presence of plaque (OR, 8.53, 95 percent CI, 1.07–68.2 and OR, 28.1, 95 percent CI, 2.67–296.4, respectively).

“Further studies are needed to ascertain its usefulness for stratifying risk in T1D women,” according to the authors.