Carotid intima-media thickness in type 2 diabetes is more strongly relatedto serum apoprotein A-I in females

Background. Dyslipidemia in type 2 diabetes has been shown to be related to the incidence of macrovascular events. Increased carotid intima-media thic kness is considered to be a marker of macrovascular disease. Main purpose. To investigate a possible relationship between lipoprotein levels and carot id intima-media thickness as a marker of early atherosclerosis in patients with type 2 diabetes. Methods. Seventy-one consecutively selected eligible patients (31 males, 40 females) with type 2 diabetes were studied. Common carotid intima-media th ickness was measured bilaterally by high-resolution ultrasound and the mean value from both sides was used for further analysis. Fasting blood samples were taken from each individual and their serum was analyzed for lipoprote in levels. Results. In the entire group of patients, intima-media thickness was invers ely related to apoprotein A-I (r = -0.33, p = 0.008) and HDL cholesterol (r = -0.23, p = 0.059) in univariate correlation analysis, and a positive cor relation between intima-media thickness and apoprotein B/apoprotein A-I rat io was found (r = 0.33, p = 0.007). When genders were analyzed separately, intima-media thickness was significantly correlated with apoprotein AI and apoprotein B/apoprotein A-I ratio in females, while no significant correlat ion of any lipid variable with intima-media thickness was observed in males . In multiple linear regression analysis, age (p = 0.005), male gender (p = 0.002) and apoprotein A-I (p = 0.035) were the only risk factors in the en tire group of diabetic patients, which significantly predicted carotid inti ma-media thickness in models adjusted for demographic and other known risk factors. As was the case in the univariate analysis, no risk factor signifi cantly predicted carotid intima-media thickness in males while age, apoprot ein A-I and B significantly predicted intima-media thickness in females. Conclusions. In the present study, low serum apoprotein A-I, a major protei n component of HDL, was found to be related to increased carotid intima-med ia thickness. This:relationship was stronger in females than in males, whic h suggests possible gender differences in the relationship between apoprote in A-I and early atherosclerotic lesions in subjects with type 2 diabetes m ellitus.