Thickness of the intima media as a new correlate for atherosclerosis risk factors in Indian type 2 diabetes patients

The evaluation of the Common Carotid Intima Media Thickness [CCIMT] assumes a special role in patients with diabetes mellitus because of being an indicator of the pan effect of atherosclerotic risk factors and an important predictor of catastrophic vascular events. Therefore, the present study was undertaken with the objective of correlating CCIMT with the numerous risk factors of atherosclerosis in diabetes patients. In the present study, 90 type 2 diabetic patients [67 males and 23 females, having assessed the CCIMT] with an age range from 32 to 78 years, with and without atherosclerotic events were recruited. Measurement of common carotid intima media thickness was measured on B-mode ultraso-nography using high frequency linear transducer on a [GE LogiQ. 700]. The results showed that significant positive correlation and independent association of CCIMT turned out with the variables age and proteinuria. However, waist/hip ratio, duration of diabetes mellitus, systolic blood pressure, glycosylated hemoglobin, triglyceride, and total cholesterol/HDL cholesterol also had positive correlation with CCIMT, but they could not achieve the level of statistical significance. The patients who had higher CCIMT values and high odds ratios for atherosclerotic events had significantly higher durations of diabetes, hypertension and presence of dyslipidemia. This study has proven that age and proteinuria are the strongest correlates of CCIMT in type 2 diabetes mellitus. It is also suggested that further large size studies are needed to reconfirm similar results

Correlation of common carotid intima media thickness with atherosclerotic cardiovascular events in patients with type 2 diabetes mellitus

Vascular complications are a major cause of morbidity and mortality in patients with diabetes mellitus and affect quality of life. Atherosclerosis, which is the major underlying risk factor, is accelerated in diabetes. To reduce morbidity and mortality, identification of patients with a high risk for development of vascular events is necessary. Apart from other risk prediction models, detection of sub clinical atherosclerosis at common carotid site by B- mode ultrasonography which is a noninvasive and reliable method, can add to the benefit and improve risk prediction. Population based studies have revealed that increased Common Carotid Intima Media Thickness [CCIMT] is associated with prevalent coronary artery disease and is a surrogate marker of cardiovascular events. To evaluate whether increased CCIMT is associated with increased risk of cardiovascular events in patients with type 2 diabetes. A total of 90 patients with type 2 diabetes who were included in the study, were divided in two groups. Group 1: without vascular events and group 2: with vascular events. Apart from patient's demographics, detailed history of events physical examination, thorough blood analysis for fasting, post postprandial blood sugar, serum cholesterol, TG, renal function test glycosylated Hb, chest X-ray, ECG were recorded. CCIMT was measured by B-mode ultrasonography using high frequency linear transducer, by a specialist radiologist [blind to all clinical and laboratory findings] by standard protocol as described in literature. Mean of the three readings on each side were used for statistical analysis. Our results showed that of the 90 patients studied, 45 diabetes mellitus[D.M.] patients had atherosclerotic events and significantly higher CCIMT values [mean value of 1.005 +/- 0.17 mm] whereas 45 comparable DM patients without atherosclerotic events had lower CCIMT values [0.798 +/- 0.12 mm] [p<0.0001]. A higher CCIMT value [>0.9mm] had a statistically significant association with high odds ratios for atherosclerotic events like Ischemic heart disease, Cerebrovascular accident and Peripheral vascular disease. Type 2 diabetes patients with atherosclerotic events had significantly higher CCIMT values than those without vascular events. Patients with higher values of CCIMT had high odds ratios for vascular events. Assessment of CCIMT should be done to enable prompt and prudent preventive action in type 2 diabetes patients well before an atherosclerotic event occurs