Carotid intima-media thickness in relation to macrovascular disease in patients with type 2 diabetes mellitus.
BACKGROUND
Increased carotid intima-media thickness is regarded as a marker of atherosclerosis. Type 2 diabetes mellitus is associated with a high prevalence of macrovascular disease.


OBJECTIVE
The present study aimed to examine the relationship between carotid intima-media thickness and the presence of macrovascular disease in patients with type 2 diabetes.


METHODS
71 patients with type 2 diabetes mellitus were studied. The distal common carotid artery and carotid bifurcation intima-media thickness were measured bilaterally with high-resolution ultrasonography. The relationship between the presence of coronary artery disease, cerebrovascular disease and peripheral arterial disease and carotid intima-media thickness was evaluated.


RESULTS
Patients with coronary artery disease had significantly (p = 0.048) increased intima-media thickness of the distal common carotid artery. This difference ceased to be significant after adjustment for cardiovascular risk factors. Patients with peripheral arterial disease had a significantly higher bifurcation (p < 0.0001), distal common carotid (p = 0.03) and mean intima-media thickness (p = 0.0008) than did those without peripheral arterial disease. This difference remained significant even after adjustment for other cardiovascular risk factors. In the multiple linear regression analysis, the presence of peripheral arterial disease, age and male gender significantly predicted bifurcation intima-media thickness, while age and the presence of peripheral arterial disease significantly predicted mean intima-medial thickness.


CONCLUSIONS
In the present study, the increased carotid intima-media thickness in patients with type 2 diabetes mellitus was related to the presence of peripheral arterial disease. This finding probably reflects morphologic and hemodynamic similarities between the two vascular beds and indicates that increased carotid intima-media thickness in patients with type 2 diabetes may be a marker of atherosclerosis in different locations.
Department of Internal Medicine IV, Medical Faculty, P. J. Safárik University, Kosice, Slovak Republic.
T
T
Mudríková
E
E
Szabová
I
I
Tkác
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography