Carotid Intima-Media Thickness and Plaque Burden in Type 2 Diabetes Mellitus: A Hospital-based Case-Control Study

Type 2 diabetes mellitus (T2DM) accelerates atherosclerosis, and carotid ultrasonographic assessment of intima-media thickness (IMT) and plaque offers a noninvasive method to detect subclinical vascular disease and stratify cardiovascular risk.

To evaluate and compare the IMT of the common and internal carotid arteries between patients with T2DM and age- and sex-matched healthy individuals.

This single-center, hospital-based analytical case-control study included 40 patients with T2DM and 40 age- and sex-matched healthy controls. Participants underwent clinical and biochemical assessment, and carotid IMT (common and internal carotid arteries) and plaque were measured using high-resolution B-mode ultrasonography.

Among 80 participants (40 T2DM cases and 40 controls), the groups were comparable in age (52.4 ± 14.9 vs. 51.7 ± 18.7 years; P = 0.843), sex and lifestyle factors. Body mass index was slightly higher in cases (26.9 ± 4.9 vs. 25.1 ± 3.0 kg/m2; P = 0.052). Cases had significantly higher systolic blood pressure/diastolic blood pressure (142.6 ± 11.4/87.3 ± 4.6 vs. 127.4 ± 7.2/84.1 ± 5.6 mmHg) and markedly higher glycemic indices (fasting blood sugar 160.9 vs. 90.1; postprandial blood sugar 224.9 vs. 109.9 mg/dL; all P ≤ 0.006). Triglycerides, very-low-density lipoprotein and total cholesterol were higher in cases, while high-density lipoprotein and low-density lipoprotein were similar. Mean carotid IMT was greater in cases (0.72 ± 0.17 vs. 0.61 ± 0.19 mm; P = 0.006) and plaque was more frequent (50% vs. 17.5%; P = 0.002). IMT was not significantly associated with age or lifestyle factors. Receiver operating characteristic analysis showed fair discrimination (area under the curve 0.686; P = 0.004); IMT >0.62 mm yielded 70% sensitivity and 65% specificity.

Patients with T2DM had significantly higher carotid IMT and plaque prevalence than controls, supporting carotid ultrasonography as a useful tool for detecting subclinical atherosclerosis and aiding cardiovascular risk stratification.