Association of blood glucose control with carotid plaque and pulse wave velocity in elderly patients with type 2 diabetes mellitus

Abstract

Objective To investigate the correlation of glycosylated hemoglobin(HbA1C)levels with carotid atherosclerotic plaque and pulse wave velocity (PWV) in elderly patients with type 2 diabetes mellitus (T2DM). Methods There were 130 cases of elderly patients with T2DM, aged from 60 to 92 years, of whom there were 59 males.All subjects were divided into 3 groups based on the HbA1C levels: the low level group (HbA1C<7%, n=49), the middle level group (7%≤HbA1C<8.5%, n=58)and the high level group (HbA1C≥8.5%, n=23). Height, body weight, blood pressure, blood glucose, blood lipids, HbA1C and other indexes were collected and compared among groups.In addition, carotid ultrasound and PWV examinations were performed. Results There were significant difference in levels of systolic blood pressure (SBP), fasting blood glucose (FBG), high density lipoprotein cholesterol (HDL-C), carotid intima-media thickness (IMT), plaque score, plaque stability and PWV among groups (all P<0.05). Correlation analysis showed that IMT levels were correlated with gender (r=0.389), age (r=0.296), FBG (r=0.203), HbA1C (r=0.405) and HDL-C (r=-0.208), all P<0.05.Carotid artery plaque score correlated with gender (r=0.321), age (r=0.355), HbA1C (r=0.340) and HDL-C (r=-0.249) (all P<0.01)and there is a correlation between the stability of carotid plaques with body mass index (BMI) (r=-0.286), SBP (r=-0.188), HbA1C (r=-0.368) and HDL-C (r=0.405) (all P<0.05); PWV was correlated with age (r=0.516), SBP (r=0.521), diastolic blood pressure (r=0.225), FBG (r=0.181), HbA1C (r=0.229), triglyceride (r=-0.253), total cholesterol (r=-0.311) and LDL-C (r=-0.244), all P<0.05.Moreover, there was a correlation between IMT and PWV (r=0.234, P<0.01). Logistic regression analysis showed that gender, age and HbA1C were independently associated with IMT; gender, age, BMI and HbA1C were independently associated with carotid atherosclerosis plaque score; age, HbA1C and HDL-C were independently associated with the stability of carotid atherosclerotic plaque; age and SBP were independently associated with PWV. Conclusions HbA1C, SBP, HDL-C and BMI are independent risk factors for arteriosclerosis in elderly diabetics. Key words: diabetes mellitus, type 2; Carotid stenosis; Tunica media