title: Prevalence by sex of preclinical carotid atherosclerosis in newly diagnosed type 2 diabetes.
abstract: OBJECTIVE
  There is clinical trial evidence that only early, intensive risk factor control can reduce cardiovascular disease (CVD) morbidity and mortality in type 2 diabetes (T2DM). However, there is little information regarding preclinical atherosclerosis at diabetes diagnosis. We assessed carotid atherosclerosis in new-onset T2DM and control individuals without prior CVD.
  
  
  RESULTS
  In a cross-sectional case-control study, we determined intima-media thickness (IMT) and plaque (IMT ≥1.5 mm) by ultrasound at all carotid sites in new-onset T2DM patients and controls. We assessed 106 T2DM patients, median age 62 years, 46% women, 19% smokers, 54% with hypertension, and 41% with dyslipidemia and 99 non-diabetic subjects matched by age, sex, and cardiovascular risk factors. Compared to controls, T2DM patients had higher common carotid artery (CCA)-IMT (median 0.725 vs. 0.801 mm, p = 0.01), bulb-IMT (0.976 vs. 1.028 mm, p = 0.12), and internal carotid artery (ICA)-IMT (0.727 vs. 0.802 mm, p = 0.04). The prevalence of total plaque (60% vs. 72%, p = 0.06), ICA plaque (20% vs. 42%, p < 0.01), and harboring ≥3 plaques (16% vs. 35% p < 0.01) was also higher in T2DM. Plaque score (sum of maximum plaque heights) was also higher (p < 0.01) in T2DM. Diabetic women showed more advanced carotid atherosclerosis than diabetic men when they were compared with their respective non-diabetic counterparts.
  
  
  CONCLUSIONS
  There is a high prevalence of preclinical atherosclerosis (carotid plaque presence and burden) in new-onset T2DM subjects, especially in women. Early, still reversible, preclinical atherosclerosis may explain in part why early intervention is effective to prevent CVD in this patient population.
authors.affiliation: Consorcio de Atención Primaria del Eixample (CAPSE), Grup Transversal de Recerca en Atenció Primària, IDIBAPS, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Catalan
authors.affiliation: Consorcio de Atención Primaria del Eixample (CAPSE), Grup Transversal de Recerca en Atenció Primària, IDIBAPS, Barcelona, Spain.
authors.forename: Z
authors.initials: Z
authors.lastname: Herreras
authors.affiliation: Consorcio de Atención Primaria del Eixample (CAPSE), Grup Transversal de Recerca en Atenció Primària, IDIBAPS, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Pinyol
authors.affiliation: Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Spain(1); Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sala-Vila
authors.affiliation: Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.
authors.forename: A J
authors.initials: AJ
authors.lastname: Amor
authors.affiliation: Department of Vascular Medicine and Cardiovascular Imaging, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: de Groot
authors.affiliation: Vascular Unit, Centre de Diagnòstic per l'Imatge, IDIBAPS, Hospital Clínic, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Gilabert
authors.affiliation: Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Spain(1); Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ros
authors.affiliation: Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Spain(1); Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. Electronic address: eortega1@clinic.ub.es.
authors.forename: E
authors.initials: E
authors.lastname: Ortega
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology*; D016893:Carotid Stenosis / Q000453:epidemiology / Q000473:pathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D014463:Ultrasonography
keywords: Atherosclerosis; Carotid ultrasound; Diabetes; Intima-media thickness; Plaque