Correlation of Carotid Intimomedial Thickness with Coronary Risk Factors in Type 2 Diabetic Patients

Abstract

Aims:  To  compare  the  carotid  intima-media  thickness  in  type  2  diabetic  patients  with  and  without  coronary  artery  disease  (CAD),  and to  correlate  the  intima-media  thickness  (IMT)  with known  coronary risk  factors. 

Methods:  two hundred and twenty patients  of type 2 diabetes were recruited for the  study.  History and physical examination were recorded. Laboratory investigations  included  fasting and  2-hour  post-prandial  blood  sugar ,  blood  urea,  serum  creatinine,  lipid  profile, glycated  haemoglobin, and  microalbuminuria. Ultrasonographic scanning of the carotid arteries was performed to measure the carotid IMT. For identification of cases of silent ischaemia, treadmill test (TMT) was performed.  Results:  The  study  group  was  divided  into  a  non-CAD  group  (n=80),  and  a  CAD  group (n=140).  The  mean  carotid  IMT  of  the  group  as  a  whole,  was  0.840±0.2  mm.  The mean carotid IMT was significantly higher (p<0.0001) in type 2 diabetics with CAD (both overt and silent) than in those without CAD.  In diabetics with CAD, the systolic blood pressure, diastolic blood pressure and triglycerides were found to be predictors of high mean carotid IMT. On subgroup analysis of the  cases  with  silent  ischaemia,  the  variables affecting carotid IMT were serum  creatinine,  total  cholesterol, microalbuminuria/proteinuria, serum  triglyceride  levels, and diastolic blood pressure.

Conclusion:  A high carotid IMT  is  a surrogate and  reliable  marker  of  higher  risk  of  CAD  amongst  type  2  diabetic  patients,  even  in  those  without  overt  CAD.  The study underlines the utility of carotid IMT as a simple, non-invasive, safe, and cheap screening test for the assessment of risk/prognosis of CAD in type 2 diabetics.  We  have  also  demonstrated  the  usefulness  of  measuring  IMT, as a means to detect silent  CAD among type 2 diabetics.

JNGMC Vol. 13 No. 2 December 2015, Page: 25-30