Association of carotid atherosclerosis and obesity in type 2 diabetic patients / 대한내과학회지

ABSTRACT

BACKGROUND: Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness (IMT) of the carotid artery as an indicator for early atherosclerosis. It is known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. METHODS: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2 diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. RESULTS: Carotid IMT was increased in the abdominal obese group defined by waist circumference. However, there was no significant difference in carotid IMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bioelectrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascular complications. CONCLUSIONS: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.