Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Tine Willum Hansen, University of Copenhagen, Denmark
- Second opponent: Professor Ragnar Martin Joakimsen, UiT - The Arctic University of Norway
- Third member and chair of the evaluation committee: Professor Torild Skrivarhaug, University of Oslo
Chair of the Defence
Professor Marte Lie Høivik, University of Oslo
Principal Supervisor
Kari Anne Sveen, Oslo University Hospital
Summary
Individuals with type 1 diabetes are at increased risk of developing coronary artery disease (CAD) due to accelerated atherosclerosis, but the underlying mechanisms behind this are not fully understood. However, there are individuals who have survived with type 1 diabetes for many decades without developing CAD.
This thesis aimed to investigate success factors for surviving with type 1 diabetes for more than 45 years without CAD, by exploring associations between biological markers and presence and degree of CAD or previously established coronary heart disease (CHD) in people with long-term type 1 diabetes.
Using data from the cross-sectional Dialong study, laboratory analyses of biological markers of gut-related inflammation and lipoproteins were combined with findings on computed topography coronary angiography and reviews from medical records.
Intestinal fatty acid binding protein (I-FABP) was associated with presence of obstructive CAD or previously established CHD.
Low levels of all types of LDL particles were associated with having coronary arteries free from atherosclerosis. Also, both the CHD event-free long-term survivors of type 1 diabetes and a comparison cohort of CHD event-free long-term survivors of familial hypercholesterolemia had higher levels of larger HDL particles compared to CHD event-free controls.
The findings highlight biomarkers associated with both risk and protection of CAD in long-term type 1 diabetes and suggest that gut mucosa damage may be contributory in the process of coronary atherosclerosis. The findings also indicate different roles of distinctive lipoprotein subclass particles in terms of risk and protection of CAD and emphasize the importance of lipid management to prevent CAD in these high-risk individuals.
Additional information
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