title: Relationship between intima-media thickness of the common carotid artery and arterial stiffness in subjects with and without type 2 diabetes: a case-series report.
abstract: BACKGROUND
  We examined the relationship between the intima-media thickness of the common carotid artery (CCA-IMT) and arterial stiffness, assessed by pulse wave velocity (PWV), the ambulatory arterial stiffness index (AASI) and the augmentation index (AIx) in subjects with and without type 2 diabetes.
  
  
  METHODS
  A case-series study was made in 366 patients (105 diabetics and 261-non-diabetics). Ambulatory blood pressure monitoring was performed on a day of standard activity with the SpaceLabs 90207 system. AASI was calculated as "1-slope" from the within-person regression of diastolic-on-systolic ambulatory blood pressure readings. PWV and AIx were measured with the SphygmoCor system, and a Sonosite Micromax ultrasound unit was used for automatic measurements of CCA-IMT.
  
  
  RESULTS
  PWV, AASI and CCA-IMT were found to be greater in diabetic patients, while no differences in AIx were observed between the two groups. CCA-IMT was independently correlated to the three measures of arterial stiffness in both groups. We found an increase in CCA-IMT of 0.40, 0.24 and 0.36 mm in diabetics, and of 0.48, 0.17 and 0.55 mm in non-diabetics for each unit increase in AASI, AIx and PWV. The variability of CCA-IMT was explained mainly by AASI, AIx and gender in diabetic patients, and by age, gender, AASI and PWV in non-diabetic patients.
  
  
  CONCLUSIONS
  CCA-IMT showed a positive correlation to PWV, AASI and AIx in subjects with and without type 2 diabetes. However, when adjusting for age, gender and heart rate, the association to PWV was lost in diabetic patients, in the same way as the association to Alx in non-diabetic patients. The present study demonstrates that the three measures taken to assess arterial stiffness in clinical practice are not interchangeable, nor do they behave equally in all subjects.
authors.affiliation: Primary Care Research Unit, La Alamedilla Health Center, Salamanca, Spain. magomez@usal.es
authors.forename: Manuel Angel
authors.initials: MA
authors.lastname: Gómez-Marcos
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Recio-Rodríguez
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Patino-Alonso
authors.forename: Cristina
authors.initials: C
authors.lastname: Agudo-Conde
authors.forename: Leticia
authors.initials: L
authors.lastname: Gómez-Sánchez
authors.forename: Emiliano
authors.initials: E
authors.lastname: Rodríguez-Sánchez
authors.forename: Carlos
authors.initials: C
authors.lastname: Martín-Cantera
authors.forename: Luís
authors.initials: L
authors.lastname: García-Ortiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation; D015924:Blood Pressure Monitors; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D012044:Regression Analysis; D013030:Spain; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography