The combination of carotid and lower extremity ultrasonography increases the detection of atherosclerosis in type 2 diabetes patients.
OBJECTIVE
To evaluate the prevalence of atherosclerosis detected by both carotid and lower extremity ultrasonography in hospitalized Chinese type 2 diabetic patients and to examine whether plaque formation in the carotid arteries could be an indicator of generalized atherosclerosis in type 2 diabetes mellitus.


METHODS
Totally, 709 hospitalized Chinese type 2 diabetic patients (men 357, women 352) aged from 18 to 88 years were included. Both carotid and lower extremity atherosclerosis were assessed by Doppler ultrasound. Atherosclerosis was defined as the presence of either the carotid or lower extremity plaque in any of the above-mentioned arteries segments. The prevalence of atherosclerosis was calculated, and the risk factors associated with atherosclerosis were evaluated using binary logistic regression.


RESULTS
The prevalence of atherosclerosis was 81.23% in male and 77.56% in female type 2 diabetic patients, respectively. There was no significant difference in the prevalence of atherosclerosis in patients between the sexes. The prevalence of atherosclerosis was significantly higher in the lower extremity arteries than in the carotid arteries (73.91% and 44.43%, respectively, P<.001). Atherosclerosis was significantly associated with smoking, age, duration of diabetes, systolic blood pressure, total number of white blood cells, and mean carotid and femoral intima-media thickness (IMT).


CONCLUSIONS
The prevalence of atherosclerosis was very high in Chinese inpatients with type 2 diabetes. Carotid atherosclerosis could not be an indicator of generalized atherosclerosis in type 2 diabetes. The combination of carotid and lower extremity ultrasound examination can significantly improve the detection of atherosclerosis in type 2 diabetes.
Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai key Laboratory of Diabetes Mellitus, Shanghai, China.
Lianxi
L
Li
Haoyong
H
Yu
Jiaan
J
Zhu
Xing
X
Wu
Fang
F
Liu
Feng
F
Zhang
Qing
Q
Li
Songhua
S
Wu
Yuqian
Y
Bao
Weiping
W
Jia
D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D050197:Atherosclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count / Q000706:statistics & numerical data; D035002:Lower Extremity / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D018608:Ultrasonography, Doppler / Q000379:methods
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human