Risk factors for asymptomatic atherosclerosis in Japanese type 2 diabetic patients without diabetic microvascular complications

• Published in: Metabolism, clinical and experimental clinical and experimental, 2003-10, Vol.52 (10), p.1302-1306
• Main Authors: Goya, K, Kitamura, T, Inaba, M, Otsuki, M, Yamamoto, H, Kurebayashi, S, Sumitani, S, Saito, H, Kouhara, H, Kasayama, S, Kawase, I
• Format: Article
• Language: English
• Subjects: Aged; Analysis of Variance; Arteriosclerosis - blood; Arteriosclerosis - diagnostic imaging; Arteriosclerosis - ethnology; Arteriosclerosis - etiology; Associated diseases and complications; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Glucose - metabolism; Cardiology. Vascular system; Carotid Arteries - diagnostic imaging; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Confounding Factors (Epidemiology); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Fasting; Glycated Hemoglobin A - metabolism; Humans; Hypertension - complications; Japan - ethnology; Logistic Models; Male; Medical sciences; Middle Aged; Risk Factors; Smoking - adverse effects; Ultrasonography
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/S0026-0495(03)00197-5

Atherosclerotic vascular diseases are frequently associated with diabetes mellitus. There has been increasing evidence showing that the atherosclerotic diseases in diabetic patients are distinct from diabetic microvascular complications as to their pathophysiology and epidemiology. However, we have no information on the prevalence of asymptomatic atherosclerosis in diabetic patients before the onset of microvascular diseases. In the present investigation, we aimed to evaluate risk factors for the atherosclerosis in type 2 diabetic patients without the microvascular diseases. For this purpose, we evaluated atherosclerotic change of carotid arteries in 125 Japanese type 2 diabetic patients who had neither atherosclerotic vascular diseases nor diabetic microvascular complications. When atherosclerotic change was defined as the mean intima-media thickness (IMT) of ≥ 1.1 mm and/or the presence of plaque lesion, 50% of patients had atherosclerosis of the carotid arteries. Risk factors for the carotid atherosclerosis were age, low-density lipoprotein (LDL)-cholesterol, hypertension, and diabetes treatment. Age and LDL-cholesterol were associated with mean IMT. Age, diabetes treatment, LDL-cholesterol, and hypertension were positively associated with plaque lesion, while high-density lipoprotein (HDL)-cholesterol was negatively associated with it. Fasting plasma glucose, glycosylated hemoglobin (HbA 1c), and known diabetes duration remained unassociated with any parameters of asymptomatic atherosclerosis of the carotid arteries. These results indicate that glycemic control is unrelated with asymptomatic atherosclerosis in type 2 diabetic patients without diabetic microvascular complications. Conventional risk factors and diabetes treatment are independently associated with atherosclerosis of the carotid arteries in these patients.