Abstract: TH-PO724

Coronary Artery Calcification Scores and Intrarenal Hemodynamic Function in Adults with Type 1 Diabetes of ≥50 Years’ Duration: Results from Canadian Study for Longevity in Type 1 Diabetes

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Lovshin, Julie A, University of Toronto, Toronto, Ontario, Canada
  • Tse, Josephine, University of Toronto, Toronto, Ontario, Canada
  • Orszag, Andrej, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
  • Scarr, Daniel, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
  • Weisman, Alanna, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
  • Keenan, Hillary A., Joslin Diabetes Center, Boston, Massachusetts, United States
  • Brent, Michael, University of Toronto, Toronto, Ontario, Canada
  • Paul, Narinder, University of Toronto, Toronto, Ontario, Canada
  • Bril, Vera, University of Toronto, Toronto, Ontario, Canada
  • Perkins, Bruce A., University of Toronto, Toronto, Ontario, Canada
  • Cherney, David, University of Toronto, Toronto, Ontario, Canada
  • Bjornstad, Petter, Children's Hospital Colorado, Aurora, Colorado, United States
  • Lovblom, Leif Erik, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
  • Lytvyn, Yuliya, University of Toronto, Toronto, Ontario, Canada
  • Boulet, Genevieve, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
  • Farooqi, Mohammed A. Malik, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
  • Bai, Johnny-Wei, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
  • Lai, Vesta S, University of Toronto, Toronto, Ontario, Canada
  • Cham, Leslie, University of Toronto, Toronto, Ontario, Canada
Background

Diabetic nephropathy (DN) carries a significant risk for premature cardiovascular (CV) mortality. It is unclear whether atherosclerosis associates with intrarenal hemodynamic dysfunction in type 1 diabetes (T1D).

Methods

T1D (n=69) and age/sex-matched controls without diabetes (n=73) underwent CAC volume scoring by electron beam CT [mean age 65±8 years, 81(57%) female]. Gold standard measures of glomerular filtration rate [GFRINULIN] and effective renal plasma flow [ERPFPAH] were used, and renal blood flow [RBF], renal vascular resistance [RVR], and afferent (RA) and efferent (RE) arteriole resistances were derived from Gomez’ equations. The cohort was dichotomized to high (≥300 AU) or low (<300 AU) CAC and stratified by T1D status. Additionally, linear regression was used to examine relationships between CAC (transformed) and intrarenal hemodynamic function, adjusting for age, sex, and HbA1c.

Results

Compared to controls, T1D subjects had higher prevalence of high CAC (68 vs. 14%, p<0.001) and median CAC volumes (1000[222,2373] AU vs. 1[0,75] AU, p<0.001). Mean baseline GFRINULIN was 103±17 mL/min/1.73m2 in T1D and 106±19 mL/min/1.73m2 in controls (p=0.34). In T1D, high CAC was associated with higher HbA1c, presence of neuropathy, and a history of macrovascular disease. In T1D and in controls, no parameter of intrarenal hemodynamic function including GFR

Conclusion

Despite the strong epidemiologic relationships between DN and CV disease, the presence of atherosclerosis did not impact intrarenal hemodynamic function to RAAS activation in older adults with longstanding T1D.