Carotid Intima Media Thickness in Young Peruvians With Onset of Type 2 Diabetes Mellitus, an Early Marker of Vascular Compromise

Abstract

Objective: To evaluate the relationship between the thickness of the carotid intima media (GIMT) with clinical and laboratory parameters in young people to identify asymptomatic endothelial dysfunction and prevent future vascular complications. Methods: This is a cross-sectional study of 81 adolescents from 10 to 18 years of age distributed in three groups: (i) 27 with onset of type 2 diabetes (DM2), (ii) 22 were non-diabetic obese; and (iii) 32 with normal weight, non-diabetic BMI from a National Reference Hospital in Lima, Peru. Laboratory evaluation consisted of fasting glucose levels, HbA1C, lipid profile, us-CRP, and Doppler ultrasound for measurement of the common carotid artery (right and left, both?). Results: In total 81 participants, 27 of them with a previous diagnosis of type 2 diabetes mellitus, of which 22 obese patients without the onset of type 2 diabetes mellitus and 32 normal weight without onset of type 2 diabetes mellitus, the median for age was 20, 19.5 and 20 years respectively, with a predominance of the female sex in the three groups; the median time of illness in years for the study group was 6 years (IQR 3–8) with DM2; Regarding treatment, metformin was the main drug used (20 patients) followed by sulfonylureas (glimepiride and glyburide, 9 patients), insulin (7 patients) and DPP4 inhibitors (vildagliptin and sitagliptin, 06 patients); Differences were found between the groups of patients with DM2, obese patients without DM2, and normal weight subjects without DM2, this difference being stronger in terms of body mass index (26.29, 31.35, 23.73 kg / m2, respectively); abdominal girth (91, 97.25, 78 cm, respectively); fasting blood glucose (126, 87.5, 94 mg / dl, respectively); glycosylated hemoglobin (7.77, 4.85, 4.97%, respectively), all of these with a p: 0.001; diastolic blood pressure (74, 68, 64 mmHg, respectively); and triglycerides (112, 112.5 and 65.5 mg / dl, respectively); The median IMT ± iqr was 0.430 ± 0.08 mm in adolescents with DM2; 0.420 ± 0.03 mm, in non-diabetic obese adolescents; and 0.405 mm ± 0.02 mm, in non-diabetic adolescents with normal weight. In general, lean, non-diabetic adolescents had a lower IMT than adolescents with DM2 (p = 0.003) and obese adolescents (p = 0.006). Conclusions: Adolescents with DM2 had a higher median IMT compared to lean, non-diabetic adolescents that reflect the onset of early vascular damage due to DM 2.