1
|
Gateva A, Assyov Y, Karamfilova V, Kamenov Z. Common carotid artery intima media thickness (CIMT) in patients with prediabetes and newly diagnosed type 2 diabetes mellitus. J Diabetes Complications 2024; 38:108766. [PMID: 38759539 DOI: 10.1016/j.jdiacomp.2024.108766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/17/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
AIM To evaluate the relationship between common carotid artery intima media thickness (CIMT) in patients with prediabetes and new-onset diabetes mellitus without proven cardiovascular disease and some classic cardio-metabolic risk factors. PATIENTS AND METHODS The study included 461 obese patients with an average age of 53.2 ± 10.7 years, divided into three groups - group 1 without carbohydrate disturbances (n = 182), group 2 with prediabetes (n = 193) and group 3 with newly diagnosed diabetes mellitus (n = 86). RESULTS The patients with new-onset diabetes had significantly higher mean CIMT values compared to those with prediabetes or without carbohydrate disturbances and a higher frequency of abnormal IMT values. CIMT correlated significantly with age, systolic BP, diastolic BP and fasting blood glucose and showed a high predictive value for the presence of diabetic neuropathy and sudomotor dysfunction. Patients with abnormal CIMT values had a higher incidence of arterial hypertension, dyslipidemia, metabolic syndrome, peripheral neuropathy, and sudomotor dysfunction. Patients who developed type 2 diabetes during follow-up had a significantly higher initial mean CIMT, which showed the highest predictive value for the risk of new-onset diabetes, with CIMT≥0.7 mm having 53 % sensitivity and 83 % specificity for the risk of progression to diabetes mellitus. CONCLUSION Patients with new-onset diabetes mellitus had significantly greater intima media thickness of the common carotid artery and a greater frequency of abnormal CIMT values compared to those with normoglycemia and prediabetes. CIMT has a high predictive value for the presence of diabetic neuropathy, sudomotor dysfunction and the risk of new onset diabetes.
Collapse
Affiliation(s)
- Antoaneta Gateva
- Medical University Sofia, Internal Medicine Department, Clinic of endocrinology, University Hospital Alexandrovska, Bulgaria.
| | - Yavor Assyov
- Medical University Sofia, Internal Medicine Department, Clinic of endocrinology, University Hospital Alexandrovska, Bulgaria
| | - Vera Karamfilova
- Medical University Sofia, Internal Medicine Department, Clinic of endocrinology, University Hospital Alexandrovska, Bulgaria
| | - Zdravko Kamenov
- Medical University Sofia, Internal Medicine Department, Clinic of endocrinology, University Hospital Alexandrovska, Bulgaria
| |
Collapse
|
2
|
Militaru M, Lighezan DF, Tudoran C, Militaru AG. Connections between Cognitive Impairment and Atrial Fibrillation in Patients with Diabetes Mellitus Type 2. Biomedicines 2024; 12:672. [PMID: 38540284 PMCID: PMC10967964 DOI: 10.3390/biomedicines12030672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/10/2024] [Accepted: 03/14/2024] [Indexed: 07/08/2024] Open
Abstract
(1) Background: Cognitive decline (CD), considered a precursory state of dementia, is frequently encountered in patients with diabetes mellitus type 2 (DM-2) and might even have a higher prevalence in those with associated atrial fibrillation (AF). In this study, we aimed to research if the association of DM-2 and AF favors a precocious onset of CD. (2) Methods: This study was conducted on 160 patients, featuring 50 with DM-2, 54 with DM-2 and AF, and 56 subjects without DM-2 and AF, all evaluated clinically and with five neuropsychiatric scales. (3) Results: The Mini-Mental-State-Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living Score (ADL), Instrumental Activities of Daily Living Score (IADL), and Geriatric Depression Scale (GDS-15) were significantly altered in patients with DM-2 and AF in comparison to patients without these diseases. The logistic regression model indicated that, in patients with DM-2 and AF, an increase of one year in age is associated with a 7.3% augmentation of the risk of a precocious onset of CD (MMSE < 27). (4) Conclusions: CD is more frequent in patients with DM-2, especially when associated with AF, versus those without DM-2 and AF. Our findings suggest that an older age and associated dyslipidemia represent risk factors for CD in patients with DM-2.
Collapse
Affiliation(s)
- Marius Militaru
- Department VIII, Neuroscience, Discipline of Neurology II, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania;
- Municipal Emergency Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania; (D.F.L.); (A.G.M.)
- Center of Advanced Research in Cardiology and Hemostasology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Daniel Florin Lighezan
- Municipal Emergency Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania; (D.F.L.); (A.G.M.)
- Center of Advanced Research in Cardiology and Hemostasology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Department V, Internal Medicine I, Discipline of Medical Semiology I, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Cristina Tudoran
- Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- County Emergency Hospital “Pius Brinzeu”, L. Rebreanu, Nr. 156, 300723 Timisoara, Romania
| | - Anda Gabriela Militaru
- Municipal Emergency Hospital Timisoara, Gheorghe Dima Street Nr. 5, 300254 Timisoara, Romania; (D.F.L.); (A.G.M.)
- Center of Advanced Research in Cardiology and Hemostasology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Department V, Internal Medicine I, Discipline of Medical Semiology I, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| |
Collapse
|
3
|
Rashid SA. Ultrasound Assessment of Carotid Intima-Media Thickness: Comparison between Diabetes and Nondiabetes Subjects, and Correlation with Serum Vitamin D. Radiol Res Pract 2024; 2024:7178920. [PMID: 38523880 PMCID: PMC10959580 DOI: 10.1155/2024/7178920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 03/26/2024] Open
Abstract
Methods This multicenter cross-sectional study was performed on two groups of adults (nondiabetes and type 2 diabetes) of various ages, sexes, and body mass index (BMI). CIMT for each side was measured at three segments using high-resolution ultrasound, and the mean of both sides was determined. Comparison was made between each group, and the association of CIMT with each of age, sex, BMI, serum vitamin D status, smoking, and physical activity status was studied. The chi-square test was used to compare categorical data, and binary logistic regression was utilized to ascertain the relationship between CIMT and the study variables. Results A significant difference was observed between the CIMT of the diabetes and nondiabetes group, average CIMT was 0.82 ± 0.23 mm vs. 1.12 ± 0.24 mm for the nondiabetes and diabetes group, respectively, with P value <0.005. No significant correlation was observed between serum vitamin D level and CIMT neither in the study group as a whole nor in either subgroup; however, a significant association was observed between CIMT with each of age, sex, BMI, smoking, and physical activity status. Conclusion Ultrasound is a sensitive tool for CIMT evaluation. Diabetes has a 5.4-fold higher risk of having high CIMT. Serum vitamin D level showed no significant influence on CIMT. Smoking, BMI, and physical activity are among the modifiable risk factors with significant influence on CIMT.
Collapse
|
4
|
Liao M, Chen S, Guo R. Association between carotid ultrasonographic parameters and microvascular and macrovascular complications in diabetes: A systematic review and meta-analysis. J Diabetes Complications 2023; 37:108554. [PMID: 37418962 DOI: 10.1016/j.jdiacomp.2023.108554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVE The present meta-analysis aimed to assess the association between carotid ultrasonographic parameters and diabetic microvascular and macrovascular complications. METHODS All published articles were searched in electronic databases including PubMed, Embase, Cochrane Library, and Web of Science databases from the inception to May 27, 2023. Common carotid artery intima-media thickness (CCA-IMT), carotid bifurcation intima-media thickness (CB-IMT), internal carotid artery intima-media thickness (ICA-IMT), carotid plaque, carotid plaque score, plaque number, plaque thickness, carotid atherosclerosis, and resistivity indices (RIs) of ultrasonographic parameters were assessed. The odds ratio (OR), weighted mean difference (WMD), with the 95 % confidence interval (CI) were pooled to estimate the effect. Subgroup analyses were performed in terms of the type of diabetes and study design. Sensitivity analysis was used to evaluate the robustness of the results. RESULTS A total of 25 studies involving 12,102 diabetic patients were included in this systematic review and meta-analysis. Our findings suggested the associations between increased CCA-IMT and the risk of diabetic microvascular (WMD: 0.059, 95%CI: 0.026 to 0.091, P < 0.001) and macrovascular complications (WMD: 0.124, 95%CI: 0.061 to 0.187, P < 0.001) including cardiovascular events (OR: 2.362, 95%CI: 1.913 to 2.916, P < 0.001). Subgroup analyses also elaborated an association between CCA-IMT and diabetic microvascular and macrovascular complications. The results of sensitivity analysis show that the association is relatively stable. CONCLUSION Our findings revealed associations between carotid ultrasonographic parameters and microvascular and macrovascular complications of diabetes. Application of the carotid ultrasonographic parameters could be a non-invasive method for the early detection of long-term complications of diabetes.
Collapse
Affiliation(s)
- Meimei Liao
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan 430060, PR China
| | - Sen Chen
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, PR China
| | - Ruiqiang Guo
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan 430060, PR China.
| |
Collapse
|
5
|
Adekoya AO, Olatunji AA, Akinola RA, Odusan O, Adekoya AO, Olusola-Bello MA, Olawale OO. Ultra sonographic indices of the carotid artery in healthy adult population of southwest, Nigeria: a cross-sectional study. Pan Afr Med J 2023; 44:97. [PMID: 37229299 PMCID: PMC10204103 DOI: 10.11604/pamj.2023.44.97.30386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 02/14/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction atherosclerosis develops insidiously, offering time and opportunities for early detection. Screening for subclinical atherosclerosis via structural wall changes and flow velocities among apparently healthy adults using carotid ultrasonography may help its early detection, offer timely intervention and reduce morbidity and mortality. Methods a cross-sectional study of 100 participants with a mean age of 56.1 ± 6.9 years, were enrolled from a community population. Both carotid arteries were examined for plaques, carotid intima-media thickness (CIMT), and flow velocities - peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI) using 4-12MHz linear array transducer. Visceral obesity, serum lipids, and blood glucose were also evaluated and correlated with ultrasound findings. Results the mean CIMT was 0.07 ± 0.02cm and 15% of the participants had increased CIMT. Statistically significance but weak correlations were observed between CIMT and FBG (r = 0.199, p = 0.047), EDV (r =0.204, p= 0.041), PI (r = -0.287, p = 0.004) and RI (r = -0.268, p =0.007). Statistically significance with modest correlations were observed between EDV and PSV (r = 0.48, p = 0.000), PI (r = -0.635, p = 0.000) and RI (r = -0.637, p = 0.000). The PI and RI showed strong correlation with statistical significance (r= 0.972, p = 0.000). Conclusion statistical significance in the flow velocities, derived flow indices and increased CIMT may be an early indication of subclinical atherosclerosis. Therefore, ultrasonography may facilitate its early detection and possible prevention of complications.
Collapse
Affiliation(s)
| | | | | | - Olatunde Odusan
- Department of Internal Medicine, Endocrine Unit, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Adesola Olubunmi Adekoya
- Department of Pediatrics, Endocrine Unit, Babcock University Teaching Hospital, Ilisan-Remo, Nigeria
| | | | | |
Collapse
|
6
|
Wen H, Yu H. Correlation analysis of carotid plaque in young patients with newly diagnosed type 2 diabetes and platelet-to-lymphocyte ratio and neutrophil-lymphocyte ratio. Vascular 2023; 31:90-97. [PMID: 35085053 DOI: 10.1177/17085381211052362] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Platelet-to-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) have been reported to be related to atherosclerosis. The relationship between PLR, NLR, and carotid atherosclerotic plaque in young patients with newly diagnosed type 2 diabetes has not been clinically reported. This study aimed to analyze the relationship between PLR, NLR, and carotid plaques in young patients with newly diagnosed type 2 diabetes. METHOD The total 268 patients were divided into the intima-media-thickening (IMT) group (116 cases) and plaque group (152 cases). The plaque group was divided into grade I (62 cases), grade II (47 cases), and grade III groups (43 cases). The counts of platelets, neutrophils, and lymphocytes were determined. RESULTS The diagnostic effect of PLR and NLR was evaluated by the receiver-operating characteristic curve (ROC) and areas under the curve (AUC). The PLR and NLR values in the observation group were higher than those in the control group; these two values in the plaque group were also higher than those in the IMT group. The two values in the grade III plaque group were higher than those in grade II. The values in the grade II plaque group were also higher than those in the grade I plaque group. The ROC of PLR and NLR were 0.722 and 0.653, and the AUC of PLR and NLR were 111.086 and 2.240. PLR yielded a sensitivity of 0.789 and a specificity of 0.612. Neutrophil-lymphocyte ratio yielded a sensitivity of 0.809 and a specificity of 0.511. CONCLUSION The PLR and NLR may be related to carotid inflammation in patients and positively correlated with carotid plaque.
Collapse
Affiliation(s)
- Huijun Wen
- Department of Neurology, Baoji Municipal Central Hospital, Baoji, Shaanxi, P.R. China
| | - Hai Yu
- Department of Neurology, Baoji Municipal Central Hospital, Baoji, Shaanxi, P.R. China
| |
Collapse
|
7
|
Ghannam N, Alahmed S, Aldahash R, Aljohani N, Alshammary A, Amir A, Kamal A, Khader S, Salah M, Shalabi H, Abdallah A, Elboghdady A. Addressing the Continuum of Dysglycaemia and Vascular Complications in Prediabetes and Type 2 Diabetes: Need for Early and Intensive Treatment. Diabetes Metab Syndr Obes 2023; 16:105-115. [PMID: 36760588 PMCID: PMC9844108 DOI: 10.2147/dmso.s396621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
The onset of type 2 diabetes increases the risk of vascular complications and death. We know now that that this risk begins long before the diabetes diagnosis. Prediabetes and type 2 diabetes are not separate entities in practice and exist within a continuum of dysglycaemia and vascular risk that increases in severity over time. This excess risk requires early intervention with lifestyle therapy supported with pharmacologic antidiabetic therapy, intensified promptly where necessary throughout the duration of the diabetes continuum. Metformin is an evidence-based treatment for preventing prediabetes and improves cardiovascular outcomes in people with type 2 diabetes from diagnosis onwards. Newer agents (SGLT2 inhibitors and GLP-1 agonists) are appropriate for people presenting with type 2 diabetes and significant cardiovascular comorbidity. Additional therapies should be used without delay to achieve patients' individualised HbA1c goals and to minimise cardiovascular risk.
Collapse
Affiliation(s)
- Nadia Ghannam
- Ghannam Clinic, Jeddah, Saudi Arabia
- Correspondence: Nadia Ghannam, Ghannam Clinic, King Abdulaziz Road, Jeddah, 21411, Saudi Arabia, Email
| | | | - Raed Aldahash
- Ministry of National Guard (Health Affairs) and King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Afaf Alshammary
- Ministry of National Guard (Health Affairs), King Abdulaziz Medical City, Riyadh and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ashraf Amir
- Family Medicine International Medical Center, Jeddah, Saudi Arabia
| | | | - Said Khader
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Mohammed Salah
- Cairo University, Cairo, Egypt and GNP Hospital, Jeddah, Saudi Arabia
| | - Hani Shalabi
- University of Jeddah, Jeddah, Saudi Arabia
- Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | | | | |
Collapse
|
8
|
Gottwald-Hostalek U, Gwilt M. Vascular complications in prediabetes and type 2 diabetes: a continuous process arising from a common pathology. Curr Med Res Opin 2022; 38:1841-1851. [PMID: 35833523 DOI: 10.1080/03007995.2022.2101805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The term, "prediabetes", describes a state of hyperglycaemia that is intermediate between true normoglycaemia and the diagnostic cut-offs for indices of glycaemia that are used to diagnose type 2 diabetes. The presence of prediabetes markedly increases the risk of developing type 2 diabetes. Numerous randomized, controlled evaluations of various agents have demonstrated significant prevention or delay of the onset of type 2 diabetes in subjects with prediabetes. Intensive lifestyle interventions and metformin have been studied most widely, with the lifestyle intervention being more effective in the majority of subjects. The application of therapeutic interventions at the time of prediabetes to preserve long-term outcomes has been controversial, however, due to a lack of evidence relating to the pathogenic effects of prediabetes and the effectiveness of interventions to produce a long-term clinical benefit. Recent studies have confirmed that prediabetes, however defined, is associated with a significantly increased risk of macrovascular and microvascular complications essentially identical to those of diabetes, and also with subclinical derangements of the function of microvasculature and neurons that likely signify increased risk of compilations in future. Normoglycaemia, prediabetes and type 2 diabetes appear to be part of a continuum of increased risk of adverse outcomes. Long-term (25-30 years) post-trial follow up of two major diabetes prevention trials have shown that short-term interventions to prevent diabetes lead to long-term reductions in the risk of complications. These findings support the concept of therapeutic intervention to preserve long-term health in people with prediabetes before type 2 diabetes becomes established.
Collapse
|
9
|
Chai S, Wang D, Yao B, Xu L, Ji L, Zhang X. The effect of education and mobile health management on improvement of blood glucose with type 2 diabetes mellitus. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01210-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
10
|
Koeder C, Hahn A, Englert H. Effect of a 6-Month Controlled Lifestyle Intervention on Common Carotid Intima-Media Thickness. J Nutr Health Aging 2021; 25:869-877. [PMID: 34409964 DOI: 10.1007/s12603-021-1628-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The intima-media thickness of the common carotid artery (ccIMT) is an established risk marker for cardiovascular disease (CVD). However, it is unclear whether lifestyle interventions can easily demonstrate an improvement in ccIMT. The objective was to test if our intervention would beneficially affect ccIMT (among other CVD markers). DESIGN Non-randomized controlled trial. SETTING Rural northwest Germany. PARTICIPANTS Middle-aged and elderly participants from the general population (intervention: n = 114; control: n = 87). INTERVENTION A community-based, 6-month controlled lifestyle intervention focusing on four areas of lifestyle change: a plant-based diet, physical activity, stress management, and an improved social life. A strong emphasis was on dietary change. MEASUREMENTS We tested whether ccIMT change from baseline to 6 months was different between groups. RESULTS With all participants included, no significant difference in mean ccIMT change between groups was observed (p = 0.708). However, in a subgroup analysis with participants with high baseline mean ccIMT (≥0.800 mm) a significant difference in mean ccIMT change between intervention (-0.023 [95% CI -0.052, 0.007] mm; n = 22; baseline mean ccIMT: 0.884 ± 0.015 mm) and control (0.041 [95% CI 0.009, 0.073] mm; n = 13; baseline mean ccIMT: 0.881 ± 0.022 mm) was observed (p = 0.004). Adjusting for potential confounders did not substantially alter the results. CONCLUSION The results indicate that healthy lifestyle changes can beneficially affect ccIMT within 6 months and that such a beneficial effect may be more easily demonstrated if participants with high baseline ccIMT are recruited. The observed effect is of relevance for the prevention of CVD events, including myocardial infarction and stroke.
Collapse
Affiliation(s)
- C Koeder
- Christian Koeder, Department of Nutrition, University of Applied Sciences Münster, Corrensstr. 25, 48149 Münster, Germany;
| | | | | |
Collapse
|
11
|
Zhu X, Chen Z, Yang P, Liu L, Wu L, Wang Y. The association of subclinical atherosclerosis with prediabetes is stronger in people with dyslipidaemia than in those with normoglycaemia: A cross-sectional study in Chinese adults. Prim Care Diabetes 2020; 14:760-767. [PMID: 32739221 DOI: 10.1016/j.pcd.2020.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 06/08/2020] [Accepted: 07/16/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Prediabetes is associated with a high risk of cardiovascular disease (CVD) and often occurs with dyslipidaemia. The present study investigated the association between subclinical atherosclerosis profiles and prediabetes with and without dyslipidaemia. METHODS This cross-sectional analysis included 4786 participants (1441 subjects with prediabetes and 3345 healthy controls). Prediabetes was defined by fasting plasma glucose (FPG) 5.6-6.9mmol/L or HbA1c 5.7-6.4% without antidiabetic drugs. Different markers of subclinical atherosclerosis were analysed: the carotid intima-media thickness (CIMT), carotid plaques (CP), and brachial-ankle pulse wave velocity (baPWV). RESULTS Subclinical atherosclerosis was significantly more prevalent in prediabetic subjects than in normoglycaemic subjects (P<0.001). Only individuals with prediabetes in the dyslipidaemic group had significantly elevated adjusted odds ratios for subclinical atherosclerosis profiles. When stratified by FPG-only, HbA1c-only or both, the three subcategories in combination with dyslipidaemia shared a similarly increased risk of subclinical atherosclerosis compared to normoglycaemia without dyslipidaemia (P<0.05). The risk profile increased directionally from FPG-only to HbA1c-only to both overall. CONCLUSION Our data suggest that subclinical atherosclerotic changes in the prediabetic state are mainly seen in dyslipidaemic subjects. Thus, strategies to prevent atherogenic changes might focus on persons with prediabetes combined with dyslipidaemia, especially for the prediabetes-both subcategory, because of potential effects on CVD risk.
Collapse
Affiliation(s)
- Xiaoling Zhu
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Zhiheng Chen
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Health Management Research Center, Central South University, Changsha, Hunan, China.
| | - Pingting Yang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Health Management Research Center, Central South University, Changsha, Hunan, China.
| | - Lei Liu
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Health Management Research Center, Central South University, Changsha, Hunan, China.
| | - Liuxin Wu
- Health Management Research Center, Central South University, Changsha, Hunan, China; Zhongguancun Xinzhiyuan Health Management Institute, Beijing, China.
| | - Yaqin Wang
- Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Health Management Research Center, Central South University, Changsha, Hunan, China.
| |
Collapse
|
12
|
Prediabetes Is Independently Associated with Subclinical Carotid Atherosclerosis: An Observational Study in a Non-Urban Mediterranean Population. J Clin Med 2020; 9:jcm9072139. [PMID: 32645918 PMCID: PMC7408832 DOI: 10.3390/jcm9072139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/29/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
This was a prospective, observational study to compare the burden of subclinical atherosclerosis as measured by carotid ultrasonography in a cohort of subjects with prediabetes vs. subjects with normal glucose tolerance (NGT) from a non-urban Mediterranean population. Atherosclerosis was assessed through carotid intima-media thickness (c-IMT), the presence/absence of carotid plaques, and plaque number. Among 550 subjects included, 224 (40.7%) had prediabetes. The mean c-IMT and the prevalence of carotid plaque were significantly higher in the prediabetes group compared to the NGT group (0.72 vs. 0.67 mm, p < 0.001; and 37.9% vs. 19.6%; p < 0.001, respectively). Older age, male gender, and increased systolic blood pressure were positively correlated with c-IMT and were independent predictors of the presence of plaques. In contrast, prediabetes and low-density lipoprotein (LDL)-c were predictors of the presence of plaque (odds ratio [OR] = 1.64; 95% confidence interval [CI] = 1.05-2.57; p = 0.03 and OR = 1.01; 95% CI = 1.00-1.02; p = 0.006, respectively) together with tobacco exposure and the leukocyte count (OR = 1.77; 95% CI = 1.08-2.89; p = 0.023 and OR = 1.20; 95% CI = 1.05-1.38; p = 0.008, respectively). In a non-urban Mediterranean population, prediabetes was associated with established subclinical carotid atherosclerosis. These findings could have implications for the prevention and treatment of CV risk in these subjects before the first symptoms of cardiovascular disease appear.
Collapse
|