Increased mean carotid intima media thickness in type 2 diabetes mellitus patients with non-blood pressure component metabolic syndrome: A preliminary report

Al-Nimer, Marwan S.M.; Hussein, Ismail I.

doi:10.4103/0973-3930.50710

Cited by 11 publications

(9 citation statements)

References 17 publications

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“…This finding is in keeping with the literature which supports early onset and progression of atherosclerosis on the left side because this side takes direct origin from the arch of the aorta creating anatomic differences between the sides and thus different shear stress conditions [37]. This finding was also in consonance with the reports of previous authors: Pollex et al [9], Naomi et al [26], Al Nimer et al [33], Liu et al [38], and Guvener et al [39].…”

Section: Discussionsupporting

confidence: 91%

Relationship between Carotid Intima-Media Thickness and Diabetes Clinical Risk Factors among Normotensive Type 2 Diabetes Mellitus among Native Black African Population

Okafor¹,

Adekanmi²,

Atalabi³

2018

IJCM

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Background: Type 2 diabetes mellitus is frequently associated with atherosclerosis with changes in the thickness of the intima-media of carotid arteries which causes increased risk of cardiovascular diseases. Cardiovascular disease is a major cause of morbidity and mortality in this group of patients. The carotid artery reflects the degree of atherosclerosis in the various vessels especially coronary arteries. Measurement of the carotid artery thickness with real time, relatively cheap and non-invasive ultrasonography method is used in monitoring atherosclerotic disease progression and response to treatment. This study is aimed at ultrasonographic evaluation of the carotid intima-media thickness (CIMT) in adult Type 2 Diabetic patients compared to non-diabetic healthy controls matched for age, gender and body mass index (BMI). And to also determine its association if any with selected clinical factors among a native Black African population. Methodology: This was a prospective case control study involving 54 adult type 2 diabetics and 54 adult non-diabetic controls. CIMT was measured at 3 segments of the extracranial carotid arteries by a 7.5-10 MHz linear transducer of a portable Mindray M5 ultrasound machine. Results: Among the native black African population studied, there was significant difference in CIMT of adult type 2 diabetics compared to healthy non-diabetics adults (p value = 0.012 and 0.001 on the right and left respectively). The mean carotid intima-media thickness in diabetics was 0.81 mm and 0.85 mm, while in non-diabetics it was 0.74 mm and 0.75 mm on the right and left respectively. The presence of diabetes showed independent positive correlation with CIMT (beta: 0.24, p value = 0.004). Age (beta: 0.30, p value = 0.001) and plasma cholesterol level (beta: 0.30, p value = 0.013

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Section: Discussionsupporting

confidence: 91%

Relationship between Carotid Intima-Media Thickness and Diabetes Clinical Risk Factors among Normotensive Type 2 Diabetes Mellitus among Native Black African Population

Okafor¹,

Adekanmi²,

Atalabi³

2018

IJCM

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“…(8), (9) In the diabetic group, male patients had higher mean CIMT (0.84±0.26 mm) as compared to the female patients (0.72±0.26 mm), (10) and similar result was found in control group as well. But, in case of metabolic syndrome, (11) the female patients had higher mean CIMT (0.74±0.19 mm) as compared to male patients (0.72± 0.22 mm). The mean CIMT also increased with the increase in duration of diabetes, (12) but had a poor correlation with glycosylated haemoglobin.…”

Section: Discussionmentioning

confidence: 80%

Measurement of Mean Carotid Artery Intima Media Thickness in Patients of Diabetes Mellitus and Metabolic Syndrome

Agarwal¹,

Jain²,

Agarwal³

et al. 2019

jemds

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BACKGROUND Diabetes mellitus is associated with various microvascular and macrovascular complications. It has been suggested that the atherosclerotic process occurs at the same time in carotid, cerebral and coronary arteries. (1) In our study, we measured the carotid artery intima media thickness in patients of diabetes mellitus and metabolic syndrome. We also tried to determine the effect of duration of diabetes on carotid artery intima media thickness. METHODS Our study was cross sectional study conducted on 200 patients of diabetes mellitus and metabolic syndrome who presented to the outpatient and in-patient departments at the Department of Medicine, MLB Medical College, Jhansi (UP) over a period of 17 months, from June 2017 to October 2018. 100 non-diabetic and nonmetabolic syndrome patients were taken as controls. Ultrasonography was performed with B-mode images of a high-resolution ultrasound scanner equipped with 7 MHz linear array transducer. The mean CIMT was compared with various variables like diabetes and its types and duration, hypertension, age, sex, body mass index, glycosylated haemoglobin (HbA1c), dyslipidaemia, microvascular complications (like nephropathy and neuropathy) and other risk factors. RESULTS Out of the 300 subjects of our study, 179 were males (93 diabetic, 26 metabolic syndrome and 60 controls) and 121 females (65 diabetic, 16 metabolic syndrome and 40 controls). So, the male: female ratio in our study was 1.48:1, with maximum number (41.77%) of patients falling in 46-60 years age. The mean CIMT was found in general to increase with age, and significantly more in diabetic patients (0.791±0.261 mm) and metabolic syndrome patients (0.726±0.218 mm) than the controls (0.645±0.135 mm). While in diabetic patients it was observed that males had higher mean CIMT (0.84±0.26 mm), in the metabolic syndrome group of patients, females had a greater value of mean CIMT (0.74±0.19 mm). It was observed that the mean CIMT values increased proportionately with the duration of diabetes. CONCLUSIONS Carotid artery intima media thickness correlates positively and strongly with age, sex, body mass index, duration of diabetes. Therefore, mean CIMT appears to us as a surrogate marker of coronary atherosclerosis. Thus, we propose that mean CIMT should be measured in all diabetic and metabolic syndrome patients to screen them for possible complications of atherosclerosis, so that timely measures can be taken.

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“…Blood pressure has been found to play a major role in the development of carotid atherosclerosis in patients with metabolic syndrome. 29 While another study demonstrated that non-blood pressure component metabolic syndrome was also associated with the development of atherosclerosis in metabolic syndrome. 30 It has also been demonstrated that systolic blood pressure contributes to increased CIMT even after adjusting for the confounding factors both in hypertensive and non-hypertensive subjects.…”

Section: Discussionmentioning

confidence: 99%

Sub-clinical atherosclerosis in hypertension.

Bashir

Shams²,

Nageen

2020

TPMJ

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Objectives: In the presence of the rising incidence of cardiovascular disease in the developing world, it is imperative to focus on prevention. Many cardio-metabolic risk factors are responsible for development of atherosclerosis in hypertensive patients. It is important to know which factors contribute the most to this condition. Study Design: Cross Sectional study. Setting: Departments of Medicine and Radiology at Creek General Hospital, United Medical and Dental College, Karachi. Period: June 2015 to June 2016. Material & Methods: Planned and the subjects were selected by consecutive sampling. Physical examination data and laboratory reports were obtained. All the subjects underwent Carotid Doppler studies. The data as analyzed on SPSS ver.20.0. Relationship of the variables to CIMT was ascertained by Pearson’s Correlation in both hypertensive and non-hypertensive subjects. P-value of <0.05 was considered significant. Results: All the variables like age, BMI, glycemic indices and the different fractions of the lipid profile were significantly higher in hypertensive patients. CIMT was significantly higher in hypertensive patients. The studied cardiometabolic variables were related to CIMT in both groups of patients but these variables were related more strongly in subjects without hypertension confirming the assumption that hypertension plays a major role in atherosclerosis. Conclusion: Hypertension is one of the most potent modifiable risk factors contributing to atherosclerosis.

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Increased mean carotid intima media thickness in type 2 diabetes mellitus patients with non-blood pressure component metabolic syndrome: A preliminary report

Cited by 11 publications

References 17 publications

Relationship between Carotid Intima-Media Thickness and Diabetes Clinical Risk Factors among Normotensive Type 2 Diabetes Mellitus among Native Black African Population

Relationship between Carotid Intima-Media Thickness and Diabetes Clinical Risk Factors among Normotensive Type 2 Diabetes Mellitus among Native Black African Population

Measurement of Mean Carotid Artery Intima Media Thickness in Patients of Diabetes Mellitus and Metabolic Syndrome

Sub-clinical atherosclerosis in hypertension.

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