Increased carotid intimal medial thickness in type 2 diabetes: relation to D-dimers

ABSTRACT

We investigated common carotid artery intimal - medial thickness [CCA-IMT] as an evidence of generalized atherosclerosis and D-dimers plasma concentrations as a measure of fibrinolytic activity, in 30 type 2 diabetic subjects [with no clinical coronary artery disease [CAD] cerebrovascular or peripheral vascular disease] and 15 healthy control subjects. Also the interrelation between CCA-IMT and D-dimers plasma concentrations and their relations with lipid status and blood sugar levels were evaluated. Diabetic subjects had significantly higher CCA-IMT and D-dimers plasma concentrations than control subjects. In diabetic subjects CCA-IMT and D-dimers plasma concentrations were significantly directly correlated with each other [P<0.01] and with FBS. 2 hPPBS, HbA[Ic], duration of diabetes, plasma fibrinogen, serum cholesterol, LDL-C and age of diabetic subjects. Diabetic subjects with better blood sugar control [FBS<140mg/dl] had significantly lower D-dimers plasma concentrations and non significantly less CCA-IMT than those with poor blood sugar control [FBS>140mg/dl]. suggesting that control of hyperglycaemia reduce haemostatic activation significantly. It is concluded that type 2 diabetic subjects without clinical CAD.cerebrovascular or peripheral vascular diseases, have a higher degree of atherosclerosis than normal control. Also this atherosclerosis is associated with enhanced Fibrin deposition and degradation as evidenced by increased D-dimers plasma concentrations. The control of hyperglycaemia and dyslipidemia that accompanies diabetes, possibly reduce or even prevent the progression of intimal medial thickening and will reduce significantly the activation of haemostasis leading to reduction of CAD and stroke risk