Carotid artery intimal media thickness and ankle brachial index as predictors for atherosclerosis in pre-diabetic patients

Abstract

Background: Atherosclerosis still remains as the major cause of death and premature disability in developed societies. Insulin resistance is a central pathogenesis feature of prediabetes, the incidence of which is rising substantially. The principal cause of end organ damage in prediabetes is premature cardiovascular atherosclerosis. Objectives: To assess the atherosclerosis in prediabetes. Materials and Methods: Patients who were nondiabetic of age group between 18 and 50 years were screened for fasting blood sugar, post-prandial blood sugar, hemoglobin A1c, after obtaining informed consent and were divided to study group and control group according to inclusion criteria. Results: In this study, abnormal carotid intimal media thickness (CIMT) was observed in 7 (17.1%), out of 41 pre-diabetic patients. This difference in CIMT findings between two groups was statistically significant. Prediabetics are at 8 times higher risk of developing abnormal CIMT than nondiabetics. Abnormal CIMT was associated with greater body mass index, waist-hip ratio, low high-density lipoprotein, high triglycerides, and abnormal ABI. Conclusion: Prediabetes was associated with higher risk of developing subclinical atherosclerosis when compared to non-diabetic patients. Lifestyle modification should be adopted to prevent the conversion of prediabetes into Type 2 diabetes mellitus and thus prevention of its complication.