N. Guvener et al., Major determinants of the carotid intima-media thickness in type 2 diabetic patients: Age and body mass index, ENDOCR J, 47(5), 2000, pp. 525-533
The present study has been designed to quantify and compare right and left
carotid intima-media thicknesses (IMT) in type 2 diabetics and healthy cont
rols. It was also intended to investigate the effects of various risk facto
rs on the carotid IMT in these subjects. A total of 122 subjects; 70 patien
ts with type 2 diabetes and 52 non-diabetic subjects as controls, were recr
uited for the study. Right and left common carotid artery stiffness indices
were assessed with ultrasonography in both groups. Age, body mass index (B
MI), duration of diabetes, cigarette smoking, lipid profile including lipop
rotein a, Chlamydia pneumonia seropositivity, glycemic indices, fasting ins
ulin levels, serum fibrinogen levels and presence of hypertension, coronary
artery disease, degenerative complications of diabetes mellitus were all a
ssessed in order to define their role as determinants of carotid artery IMT
. The difference between the groups regarding mean carotid IMT was statisti
cally significant for the left carotid arteries (p=0.028) and borderline si
gnificance was found for the right carotid arteries (p=0.055). Age has a ve
ry strong association with carotid IMT in diabetic patients (p<0.0001) with
univariate analysis. According to the results of multivariate analysis, ag
e and BMI were found to be the most important independent determinants of c
arotid TMT for both sides. When age was excluded from the model, BMI and co
ronary artery disease were found to have strong association with IMT on the
right (p=0.0036 and 0.0249) and BMI was the only significant determinant f
or the left side (p=0.0025). This study shows that carotid IMT is greater i
n diabetic subjects compared with healthy controls. For the diabetic subjec
ts, age, BMI and presence of coronary heart disease have a strong influence
on the atherosclerotic process of the carotid arteries.