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All Journal Heart Science Journal
Dyah Ayu Ikeningrum
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya-dr.Saiful Anwar General Hospital, Malang East Java, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology

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Type 1 Diabetes Mellitus and Premature Coronary Artery Disease Dyah Ayu Ikeningrum; Djanggan Sargowo; Novi Kurnianingsih; Anna Fuji Rahimah
Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen?
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.03.2

Abstract

Cardiovascular disease, which affects more than half of all diabetics, is the leading cause of morbidity and mortality in patients with type 1 and type 2 Diabetes Mellitus (DM). Around 55% of diabetes patients are thought to have it, in comparison to 2-4% of the general population. A significant risk factor for the development of Coronary Artery Disease (CAD) exists in people with Type 1 Diabetes Mellitus (T1DM). However, it is worth noting that the present Models of risk prediction for T1DM have a variety of flaws. CAD risk is expected to double or quadruple over the next two to four decades, and diabetes mellitus is the third most significant risk factor for the etiology of illness. As a result, diabetes increases the chance of developing Acute Coronary Syndromes (ACS), whose incidence surpasses 20% after seven years, compared to a rate of 3.5 percent in non-diabetics – a rate comparable to individuals who have already experienced an Acute Myocardial Infarction (AMI). Additionally, it is crucial to identify any well-defined specific risk factors for T1DM as well as any extra subclinical atherosclerosis that may influence these patients at an advanced stage of disease progression. T1DM patients have more severe lesions, a lower left ventricle (LV) ejection fraction, a higher risk of cardiac events, and a higher rate of silent ischemia when compared to non-diabetics. They continue to have impaired microcirculation and endothelial function, both of which contribute to tissue perfusion problems.
The Effect of HbA1C Variability and Lipid Profile on Carotid Intima-Media Thickness (cIMT) and Flow-mediated Dilatation (FMD) in children and adolescent with Type 1 Diabetes Mellitus at Saiful Anwar Hospital Malang Dyah Ayu Ikeningrum; Cholid Tri Tjahjono; Novi Kurnianingsih; Sasmojo Widito; Valerina Yogibuana Swastika Putri
Heart Science Journal Vol 3, No 3 (2022): Cardiovascular Disease in Young Adulthood: Who, When, and How to Screen?
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2022.003.03.4

Abstract

BackgroundThere is a correlation between diabetes mellitus type 1 (T1DM) and a higher risk of heart disease. Atherosclerosis, which can be discovered early with cIMT (Carotid Intima-Media Thickness) and Flow Mediated Dilation (FMD) tests, contributes to the development of cardiovascular disease. HbA1c fluctuation and lipid profile can have an impact on cIMT and FMD.AimThe aim of this study is to determine the influence of HbA1c variability and lipid profile on cIMT and FMD levels in children T1DM patients treated at Dr Saiful Anwar Hospital Malang.MethodsThe study utilized a cross-sectional design and included 82 participants with Type 1 Diabetes Mellitus who were routinely treated at the Dr. Saiful Anwar Hospital Malang's pediatric outpatient clinic between January - July 2019 and December 2021 and- January 2022.ResultsThe correlation test revealed no significant connection between HDL (ρ=-0,029; p=0,796), LDL (ρ=-0.213; p=0.055), TG (ρ= -0.179; p= 0.107), and total cholesterol (ρ=-0.182; p= 0.101). Association tests revealed a positive correlation between LDL (ρ=0,318; p=0,004) and total cholesterol (ρ=0,230; p=0,038) levels and IMT. The correlation coefficient between HbA1C variability and FMD as evaluated by HVS was -0.498 (ρ=0.000; p=0.05), as was the correlation coefficient between HbA1c-SD (ρ=-0.467; p=0.000) and HbA1c-CV (ρ=-0.400; p=0.000). Additionally, a significant positive connection was discovered between IMT and the value of HbA1c variability utilizing HVS (ρ=0.455; p=0.000), HbA1c-SD (ρ=0.434; p=0.000), and HbA1c-CV (ρ=0.325; p=0.003). The linear regression analysis revealed that the three variables with the greatest influence on FMD were HVS (R=0.398), LDL (R=0.316), and HbA1c-SD (R=0.293). HVS (R=0.468), LDL (R=0.268), and total cholesterol (R=0.198) were the three most impactful variables on IMT. It is known that the combination of lipid profile and HbA1c fluctuation contributes 25.1% to FMD using this model. Meanwhile, the lipid profile and HbA1c variability together accounted for 34.5% of the variance in IMT.ConclusionVariability in HbA1c and lipid profile (LDL and total cholesterol) can contribute to an increase in intima-media thickness and a decrease in brachial artery FMD in children with T1DM.  
Co-Authors Anna Fuji Rahimah Cholid Tri Tjahjono Djanggan Sargowo Novi Kurnianingsih Sasmojo Widito Valerina Yogibuana Swastika Putri