open access

Vol 46, No 6 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2011-12-28
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Clinical determinants of carotid intima-media thickness in patients with diabetes mellitus type 2

Wojciech Bartman, Krystyna Pierzchała
DOI: 10.5114/ninp.2012.32278
·
Neurol Neurochir Pol 2012;46(6):519-528.

open access

Vol 46, No 6 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2011-12-28

Abstract

Background and purpose

Early atherosclerotic changes in carotid arteries can be detected using ultrasound examination. The aim of this study was to assess correlations between intima-media thickness (IMT) and gender, age and clinical features of diabetes mellitus (DM).

Material and methods

The study group consisted of 73 patients with type 2 DM (mean age: 63.6 ± 7.5 years), and 74 controls without DM (mean age 62.2 ± 7.5 years). Analysed clinical features of diabetes included disease duration, anti-diabetic treatment, glycaemic control (HbA1c level), presence of metabolic syndrome, and complications of macroand microangiopathy. IMT was measured using ultrasonography in the carotid arteries (common – CCA, bifurcation, internal – ICA) bilaterally.

Results

Mean and maximum IMT in the CCA was greater in diabetic patients than in controls. Age and male sex, but not vascular risk factors, were independent predictors of increased IMT in all segments. Macroangiopathy correlated with IMT within both CCA in univariate analysis. After adjusting for age and gender, this relationship remained significant in the right CCA in middle-aged patients (59–67 years; p = 0.01 for mean IMT, p = 0.02 for maximum IMT). In patients without metabolic syndrome, IMT in the right CCA bifurcation correlated with HbA1c level (p = 0.05). Patients treated simultaneously with insulin and oral antidiabetic drugs had smaller IMT in the right ICA than those treated with insulin only (0.471 ± 0.105 vs. 0.678 ± 0.209 mm; p = 0.04).

Conclusions

In diabetic patients, ultrasound IMT measurement can be used to assess the cardiovascular risk and to determine indications for intensified anti-diabetic treatment. IMT is a sensitive marker of early carotid atherosclerosis, particularly on the right side.

Abstract

Background and purpose

Early atherosclerotic changes in carotid arteries can be detected using ultrasound examination. The aim of this study was to assess correlations between intima-media thickness (IMT) and gender, age and clinical features of diabetes mellitus (DM).

Material and methods

The study group consisted of 73 patients with type 2 DM (mean age: 63.6 ± 7.5 years), and 74 controls without DM (mean age 62.2 ± 7.5 years). Analysed clinical features of diabetes included disease duration, anti-diabetic treatment, glycaemic control (HbA1c level), presence of metabolic syndrome, and complications of macroand microangiopathy. IMT was measured using ultrasonography in the carotid arteries (common – CCA, bifurcation, internal – ICA) bilaterally.

Results

Mean and maximum IMT in the CCA was greater in diabetic patients than in controls. Age and male sex, but not vascular risk factors, were independent predictors of increased IMT in all segments. Macroangiopathy correlated with IMT within both CCA in univariate analysis. After adjusting for age and gender, this relationship remained significant in the right CCA in middle-aged patients (59–67 years; p = 0.01 for mean IMT, p = 0.02 for maximum IMT). In patients without metabolic syndrome, IMT in the right CCA bifurcation correlated with HbA1c level (p = 0.05). Patients treated simultaneously with insulin and oral antidiabetic drugs had smaller IMT in the right ICA than those treated with insulin only (0.471 ± 0.105 vs. 0.678 ± 0.209 mm; p = 0.04).

Conclusions

In diabetic patients, ultrasound IMT measurement can be used to assess the cardiovascular risk and to determine indications for intensified anti-diabetic treatment. IMT is a sensitive marker of early carotid atherosclerosis, particularly on the right side.

Get Citation

Keywords

intima-media thickness, ultrasonography, diabetes mellitus, microangiopathy, macroangiopathy, HbA1c

About this article
Title

Clinical determinants of carotid intima-media thickness in patients with diabetes mellitus type 2

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 46, No 6 (2012)

Pages

519-528

DOI

10.5114/ninp.2012.32278

Bibliographic record

Neurol Neurochir Pol 2012;46(6):519-528.

Keywords

intima-media thickness
ultrasonography
diabetes mellitus
microangiopathy
macroangiopathy
HbA1c

Authors

Wojciech Bartman
Krystyna Pierzchała

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