Carotid intima-media thickness in Japanese type 2 diabetic subjects - Predictors of progression and relationship with incident coronary heart disease

OBJECTIVE - To examine carotid intima-media thickness (IMT). predictors of its progression, and its relationship with incident coronary heart disease (CHD) in type 2 diabetic Japanese patients. RESEARCH DESIGN AND METHODS - Carotid IMT of 287 subjects with type 2 diabe tes (mean age 61.6 years) without CHD or cerebrovascular disease was examin ed at baseline and after a mean follow-up of 3.1 years. RESULTS - The annual progression of IMT (means +/- SEM) was 0.04 +/- 0.004 mm/year. Stepwise multivariate analysis demonstrated that independent risk factors for progress of IMT were the initial IMT (P < 0.001), the average H bA(1c) level (P < 0.001), and age (P = 0.001). Both the initial IMT (odds r atio [OR] 4.9, 95% CI 1.7-14.1) and a low average HDL cholesterol (OR 0.2, 0.1-0.8) were identified as predictors of incident nonfatal CHD (angina pec toris or nonfatal myocardial infarction; 3-year incidence 10.1%) after adju sting for age, sex, average HbA(1c), and other risk factors. CONCLUSIONS - The predictors of the progression of carotid IMT in Japanese type 2 diabetic subjects were its baseline thickness and the average HbA(1c ) during the follow-up. Baseline carotid IMT and low HDL cholesterol predic ted the incidence of nonfatal CHD.