Association of 10-Year Atherosclerotic Cardiovascular Disease Risk Score with Carotid Atherosclerosis in Middle-Aged Abdominal Obesity Patients with Type 2 Diabetes Mellitus

Abstract

Type 2 diabetes mellitus (T2DM) and Abdominal obesity (AO) are associated with a high risk of cardiovascular disease (CVD). Carotid intima-media thickness (CIMT) and carotid plaques (CP) increasingly used as a surrogate marker for atherosclerosis. Its use relies on its ability to predict future CVD. The aim of this study was to determine the association between carotid atherosclerosis and 10-year atherosclerotic cardiovascular disease (ASCVD) risk score in middle-aged AO patients with T2DM. This was a cross-sectional study with 69 middle-aged (<65 years) AO patients (defined as waist circumference (WC) ≧90 cm for Taiwan men and ≧80 cm for Taiwan women) with T2DM who had no apparent history of CVD were enrolled. We obtained information about medical history and lifestyle, clinical examinations, and biochemical evaluations. CIMT by B-mode ultrasonography was measured. Carotid atherosclerosis was considered present when the maximum CIMT was ≧0.9 mm or when the CP were detected. The 10-year ASCVD risk score was calculated using the 2013 American College of Cardiology/American Heart Association guidelines (high 10-year risk: ASCVD risk score ≧7.5%). Of this study subjects, the mean age was 56.3±5.4 years and the mean duration of diabetes was 10.3±5.7 years. The mean ASCVD risk score was 12.8±9.8, and 43 (62.3%) subjects with high 10-year ASCVD risk. We found that carotid atherosclerosis had statistically significantly correlations with the age (r=0.33, p<0.01), systolic blood pressure (SBP) (r=0.28, p=0.02), pulse pressure (PP) (r=0.28, p=0.02), mean arterial pressure (MAP) (r=0.28, p=0.02), and ASCVD risk score (r=0.31, p=0.01). The carotid atherosclerosis group was significantly associated with the high 10-year ASCVD risk group (odds ratio (OR): 5.098, 95% confidence interval (95% CI): 1.7-15.288, p<0.01). Results of multiple logistic regression showed that only 10-year ASCVD risk score (OR: 1.073, 95% CI: 1.01-1.142, p=0.02) was significantly associated with carotid atherosclerosis after adjustment for duration of diabetes, diastolic blood pressure (DBP), and lipid lowering therapy. The findings of this study suggest that 10-year ASCVD risk score is associated with carotid atherosclerosis in a group of middle-aged abdominal obese diabetes.