title: Subclinical Carotid Atherosclerosis in Asymptomatic Subjects With Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  Subjects with type 2 diabetes mellitus are considered to be at high risk for cardiovascular disease. The identification of carotid atherosclerosis is a validated surrogate marker of cardiovascular disease. Nurses are key professionals in the improvement and intensification of cardiovascular preventive strategies.
  
  
  OBJECTIVE
  The aim is to study the presence of carotid atherosclerosis in a group of asymptomatic subjects with type 2 diabetes mellitus and no previous clinical cardiovascular disease.
  
  
  METHODS
  A total of 187 patients with type 2 diabetes mellitus and 187 age- and sex-matched subjects without type 2 diabetes mellitus were studied in this cross-sectional, observational, cohort study. Standard operational procedures were applied by the nursing team regarding physical examination and carotid ultrasound assessment. Common, bulb, and internal carotid arteries were explored by measuring intima-media thickness and identifying atherosclerotic plaques.
  
  
  RESULTS
  Carotid intima-media thickness (c-IMT) and carotid plaque prevalence were significantly greater in diabetic subjects than in the control group. Carotid plaques and c-IMT were more frequent in men than in women and increased with increasing age. In the multivariate analysis, age, gender, waist circumference, systolic blood pressure, and hypercholesterolemia were positively associated with c-IMT, whereas age, gender, and weight were positively associated with carotid plaque.
  
  
  CONCLUSIONS
  The current nurse-led study shows that subjects with type 2 diabetes mellitus have a high prevalence of subclinical atherosclerosis that is associated with cardiovascular risk factors.
authors.affiliation: Esther Rubinat, RN, MSc Research Nurse, PhD Student, Department of Endocrinology and Nutrition, Hospital Universitari Arnau de Vilanova; and Institut de Recerca Biomèdica de Lleida, University of Lleida, Spain. Josep Ramon Marsal, Stat Statistician, Unitat de Suport a la Recerca de Lleida, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIA Jordi Gol), Lleida; and Unitat de Epidemiologia, Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Teresa Vidal, RN Nurse, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova; and Department of Nephrology, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Cristina Cebrian, RN Nurse, Primary Health Care Center Primer de Maig, Lleida, Spain. Mireia Falguera, MD General Practitioner, Primary Health Care Center Igualada Nord, Spain. Ma. Belen Vilanova, MD General Practitioner, Primary Health Care Center Igualada Nord, Spain. Àngels Betriu, MD, PhD Coordinator, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova; and Department of Nephrology, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Elvira Fernández, MD, PhD Head of Department and Associate Professor, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova; and Department of Nephrology, Hospital Universitari Arnau de Vilanova, Lleida, Spain. Josep Franch, MD, PhD General Practitioner, Primary Health Care Center Raval Sud; and Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain. Dídac Mauricio, MD, PhD Chief Physician, Unitat de Detecció i Tractament de Malalties Aterotrombòtiques, Hospital Universitari Arnau de Vilanova, Lleida; Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Barcelona; and Department of Endocrinology and Nutrition, Hospital Germans Trias Pujol, Badalona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Rubinat
authors.forename: Josep Ramon
authors.initials: JR
authors.lastname: Marsal
authors.forename: Teresa
authors.initials: T
authors.lastname: Vidal
authors.forename: Cristina
authors.initials: C
authors.lastname: Cebrian
authors.forename: Mireia
authors.initials: M
authors.lastname: Falguera
authors.forename: Ma Belen
authors.initials: MB
authors.lastname: Vilanova
authors.forename: Àngels
authors.initials: À
authors.lastname: Betriu
authors.forename: Elvira
authors.initials: E
authors.lastname: Fernández
authors.forename: Josep
authors.initials: J
authors.lastname: Franch
authors.forename: Dídac
authors.initials: D
authors.lastname: Mauricio
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors