Influence of diabetes mellitus on carotid intima-media thickness of non-obese, normotensive diabetic patients

Abstract

Background: Diabetes mellitus is a chronic metabolic disease of great public health importance. Macrovascular complications like stroke and myocardial infarction initially manifest as atherosclerosis which is seen as thickened arterial wall. Direct determination of the progression of atherosclerosis can be undertaken through serial ultrasound measurement of the common carotid artery (CCA) intima media thickness (IMT).
Aim: The objective of the study was to compare the IMT of the CCA in diabetic patients and healthy subjects within the same age, sex and geographic distribution.
Method: This prospective study was conducted on 100 diabetic patients and 100 non-diabetic subjects aged 21years and above. The CCAs were scanned using GE Logic 5 color Doppler scanner (2007) with 7.5MHz linear probe. Two measurements of the IMT were obtained at 1cm proximal to the right and left carotid bulbs and the mean value of the two measurements was recorded.
Results: The age range of the 200 participants comprising of 65 males and 135 females was 21-70 years with a mean age of 46.60 ±12 years. Mean CIMT was significantly higher in diabetic patients compared to normal patients (0.81+0.25mm and 0.61+0.12mm, p= 0.001). Age has significant influence on the CIMT on both groups of participants. However, male and  overweight subjects had significantly higher CIMT values than female and underweight subjects respectively only among non-diabetic subjects. The overall right and left mean CIMT in the diabetic patients and control respectively were 0.78+0.21mm, 0.83+0.37mm, 0.61+0.12mm and 0.61+0.13mm. In each group, there was no significant difference between the two sides.
Conclusion: CIMTvalues were higher among non-obese normotensive diabetic  patients compared to normal subjects. Age, sex, and BMI have effects on CIMT of non-diabetic subjects, whereas only age has significant effect on the CIMTof diabetic patients.

Keywords: Diabetes Mellitus, Carotid Intima-Media Thickness, Non-Obese,  Normotensive