Elevated carotid artery intima-media thickness levels in individuals who subsequently develop type 2 diabetes.
OBJECTIVE
We examined whether B-mode ultrasound-detected carotid artery intima-media thickness (IMT) was elevated before the onset of clinical diabetes.


RESULTS
The study population for these analyses included 1127 nondiabetic participants, 66 prediabetic participants, and 303 diabetic participants with a mean age of 49.8 years who participated in the Mexico City Diabetes Study, a prospective cohort study. Common carotid artery (CCA) and internal carotid artery (ICA) IMTs were measured bilaterally by B-mode ultrasound. Age- and sex-adjusted mean ICA and CCA IMTs were both significantly higher among prediabetic individuals [0.81 mm [95% confidence interval (CI), 0.75-0.88] and 0.72 mm [95% CI, 0.69-0.75], respectively] than in individuals who remained free of diabetes [0.71 mm (95% CI, 0.69-0.72) and 0.69 mm (95% CI, 0.68-0.69), respectively]. However, after adjustment for established cardiovascular risk factors, ICA IMT, but not CCA IMT, remained significantly higher among prediabetic individuals [0.81 mm (95% CI, 0.75-0.88) and 0.71 mm (95% CI, 0.68-0.74)] than in individuals who remained free of diabetes [0.71 mm (95% CI, 0.69-0.72) and 0.69 mm (95% CI, 0.68-0.70)].


CONCLUSIONS
The present study provides direct evidence at the vascular level that atherosclerosis levels are elevated before the clinical onset of diabetes.
Hunt
Kelly J
KJ
Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, 78229, USA. huntk@uthscsa.edu
Williams
Ken
K
Rivera
David
D
O'Leary
Daniel H
DH
Haffner
Steve M
SM
Stern
Michael P
MP
González Villalpando
Clicerio
C
D000328:Adult; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography