Lipid profile and carotid artery intima-media thickness in diabetic and non-diabetic ischaemic stroke

Abstract

Background: Stroke is one of the leading reasons for mortality throughout the world. Measurement of carotid intima media thickness (CIMT) is a reliable marker for the development of atherosclerosis and ischemic stroke (IS). The aim was to study and correlate lipid profile and CIMT in diabetic and non-diabetic IS patients. Methods: An observational study was done including 120 IS patients divided into two groups-diabetes (n=60, diabetic stroke patients) and non-diabetes (n=60, non-diabetic stroke patients) having age >18 years, admitted in Medicine and Neurology wards of G. R. Medical College, Gwalior, Madhya Pradesh, India between August 2015 to August 2016. Detailed history along with investigations such as fasting blood sugar (FBS), post prandial blood sugar (PPBS) and fasting lipid profile including triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL) and total cholesterol (TC) was done. The common and the internal carotid arteries of both sides were evaluated ultrasonographically using a high frequency linear probe. All the data were analysed using IBM SPSS-ver.20 software. Data was expressed as percentage. Analysis was performed using two-way ANOVA and independent sample student t test. Pearson correlation was used to establish the relation between the data. P values <0.05 was considered to be significant. Results: Most common age group among diabetes and non-diabetes IS patients were 51-60 years (26.66%) and 61-70 years (28.33%) respectively with male predominance (75% and 66.67% respectively). Most of the diabetic IS patients had FBS >200 mg/dl (41.66%) and PPBS >250 mg/dl, (50%). Out of 120 IS patients, 55 (45.83%) had CIMT ≤0.8 mm and 65 (54.16%) patients had CIMT >0.8 mm. Lipid parameters including TC (p=0.034), TG (p=0.022), HDL (p=0.039), VLDL (p=0.043) and LDL (p=0.017) were significantly different between groups (p<0.05). Mean CIMT in patients with diabetes and non-diabetes was 1.03±0.255 mm and 0.83±0.54 mm respectively (p=0.006). A significant positive correlation was recorded between CIMT and TC (r=0.36, p=0.006), TG (r=0.48, p=0.0001) and VLDL (r=0.46, p=0.0001) among diabetes stroke patients. Among non-diabetes stroke patients, TC (r=-0.25, p=0.042), TG (r=-0.44, p=0.0003), HDL (r=-0.33, p=0.016) and LDL (r=-0.58, p=<0.001) were negatively correlated and VLDL (r=0.92, p=<0.0001) was positively correlated with CIMT. Conclusions: Lipid parameters including TC, TG, LDL and VLDL were significantly raised in diabetic stroke patients and had a positive correlation with the risk of stroke. CIMT was significantly high in diabetic stroke patients. Correlation of lipid parameters (TC, TG and VLDL) with CIMT in diabetic stroke patients were significantly positively correlated, in non-diabetic ischemic stroke patients' lipid parameters (TC, TG, HDL and LDL) were negatively correlated.

Plasma Adiponectin and Its Correlation with Carotid Intima-Media Thickness in Obesity and in Type 2 Diabetes and Nonalcoholic Fatty Liver Disease

“…These results agree with those of Dalmas et al who reported that CIMT was higher in obese patients with T2DM as compared with obese nondiabetic and nonobese subjects; however, they did not include a group of nonobese patients with T2DM or patients with NAFLD in their study [ 36 ]. Both Pillai et al and Kota et al reported a higher CIMT in patients with diabetes as compared with nondiabetic individuals [ 37 , 38 ]. Vasilescu et al found a higher CIMT in obese patients with newly diagnosed T2DM as compared with obese nondiabetic subjects [ 39 ].…”

Association between Proinflammatory Markers, Leukocyte–Endothelium Interactions, and Carotid Intima–Media Thickness in Type 2 Diabetes: Role of Glycemic Control

“…All these correlations were maintained when we analyzed the right CIMT data, with the exception of the cholesterol/HDL index correlation. In this sense, [97] demonstrated that lipid parameters, including total cholesterol (TC), triglycerides (TG), LDL, and VLDL, were significantly higher in diabetic stroke patients and positively correlated with the risk of stroke. CIMT was significantly higher in diabetic stroke patients, and correlations of lipid parameters (TC, TG, and VLDL) with CIMT in said patients were significantly and positively correlated, while lipid parameters (TC, TG, HDL, and LDL) were negatively correlated in nondiabetic ischemic stroke patients.…”