Haemostasis and carotid artery wall thickness in non-insulin dependent diabetes mellitus

The purpose of this study was to examine the associations of carotid artery intima-media wall thickness (IMT) with hemostatic proteins and cardiovascu lar risk factors (CVRFs) in participants with and without non-insulin depen dent diabetes mellitus (NIDDM). IMT measurements were determined by high re solution B-mode ultrasound imaging of the carotid arteries in 921 participa nts with NIDDM and 11964 non-diabetic participants aged 45-64 years. Fastin g glucose, serum lipids and activated partial thromboplastin time, factor V III fibrinogen, factor VII, antithrombin III, protein C, and von Willebrand factor measurements were made. Compared to non-diabetic participants, part icipants with NIDDM had a more adverse pattern of CVRFs and a more procoagu latory profile. Participants with NIDDM had 0.06 mm (8.1%) higher mean IMT compared to non-diabetic participants after adjusting for age and gender (P < 0.001). However, only plasma fibrinogen concentrations showed statistica lly significant positive associations with IMT in both groups. After adjust ing for CVRFs and fibrinogen, mean IMT remained 0.04 mm (5.4%) higher in di abetic compared to non-diabetic participants. Despite the more procoagulato ry profile in participants with NIDDM, only plasma fibrinogen concentration s were independently associated with mean IMT. The association of NIDDM wit h mean IMT was only partly explained by CVRFs. (C) 2000 Elsevier Science Ir eland Ltd. All rights reserved.