Association between carotid plaque score and microvascular complications of type 2 diabetes
Introduction:
According to the "common soil" hypothesis, diabetic microangiopathy and macroangiopathy have a similar pathophysiological background. It has been well documented that carotid artery atherosclerosis in patients with type 2 diabetes is associated with cardiovascular complications; however, it remains unclear whether there is a similar association for microvascular complications.
Objectives:
We investigated whether the carotid plaque score and the carotid intima-media thickness (IMT) are associated with macroangiopathic and microangiopathic complications of type 2 diabetes.
Patients And Methods:
We enrolled patients with type 2 diabetes and microvascular complications or overt macroangiopathy. A B‑mode carotid ultrasound was performed in all participants, and anthropometric parameters, hemoglobin A1c (HbA1c) levels, lipid profile, and smoking status were assessed.
Results:
The study included 73 patients (mean [SD] age, 63.6 [7.5] years; 36 men [49%]). The mean (SD) diabetes duration was 11.7 (8.1) years. Microvascular complications were observed in 32 patients (43.8%), and overt macroangiopathy, in 42 (57.5%). Hypertension was reported for 60 patients (82%); dyslipidemia, for 56 (77%); obesity, for 37 (51%); and smoking, for 10 (14%). A multivariate regression analysis showed that the carotid plaque score, but not carotid IMT, was significantly associated with dyslipidemia (P = 0.03) and microangiopathy (P = 0.01).
Conclusions:
Our results indicate that, unlike carotid IMT, the carotid plaque score is independently associated with microangiopathic complications in type 2 diabetes. Patients with a high plaque score should receive special care and the most intensive treatment to stop progression of these complications.
Insights
The carotid plaque score, not intima-media thickness, is linked to microvascular complications in type 2 diabetes. This finding highlights the importance of monitoring plaque scores for managing diabetic complications.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Diabetology
Background:
- The "common soil" hypothesis suggests diabetic microangiopathy and macroangiopathy share similar causes.
- Carotid artery atherosclerosis in type 2 diabetes is linked to cardiovascular issues, but its association with microvascular complications is unclear.
Purpose of the Study:
- To investigate the association between carotid plaque score and intima-media thickness (IMT) with macroangiopathic and microangiopathic complications in type 2 diabetes.
Main Methods:
- Enrolled 73 patients with type 2 diabetes and microvascular complications or overt macroangiopathy.
- Performed B-mode carotid ultrasound, assessing anthropometric data, HbA1c, lipid profile, and smoking status.
- Utilized multivariate regression analysis to determine associations.
Main Results:
- Carotid plaque score, unlike IMT, was significantly associated with dyslipidemia (P = 0.03) and microangiopathy (P = 0.01).
- The study included 73 patients (mean age 63.6 years), with 43.8% having microvascular complications and 57.5% having overt macroangiopathy.
Conclusions:
- Carotid plaque score, independently of IMT, is associated with microangiopathic complications in type 2 diabetes.
- Patients with high carotid plaque scores require intensive management to prevent complication progression.
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