ADA: Weight Gain in Type 1 Diabetes Associated with Less Artery Calcification

CHICAGO, June 26 -- Weight gain in type 1 diabetes is associated with coronary artery calcification, but, paradoxically, that may be a sign of better cardiovascular health, investigators here reported.

"Gaining weight may reflect good or better treatment with insulin therapy, which may partly explain why participants who gained weight over time had lower mortality rates," said Trevor Orchard, M.D., of the University of Pittsburgh School of Public Health.

In a longitudinal follow-up study of diabetes complications, Dr. Orchard and colleagues found that among the two-thirds of patients with radiographically confirmed coronary artery calcification, heavier patients tended to have less severe disease, they said at the American Diabetes Association meeting.

The protective effect of weight among patients with coronary calcification was especially pronounced among women, the authors found.

"This is not a firm recommendation to people with type 1 diabetes to put on weight, but it does raise the possibility that weight recommendations in type 1 diabetes may be somewhat different than those for the general population, and emphasizes the complex relationship between body fat and cardiovascular risk in diabetes," said Dr. Orchard.

The authors evaluated the relationship between adiposity and coronary artery calcification in 315 men and women with type 1 diabetes who were participants in the Pittsburgh Epidemiology of Diabetes Complications Study. The mean patient age was 42, and the mean duration of type 1 diabetes was 34 years.

For the study, patients were evaluated for coronary artery calcification, visceral fat, and subcutaneous fat by electron beam tomography, and were measured for body-mass index and waist circumference.

The authors compared the presence of any calcification and total coronary artery calcification score across quartiles of adiposity.

They found that among both men and women there was a positive relationship between the presence of calcification and visceral adiposity (P for trend