Abstract
BackgroundHigh body mass index (BMI) is a risk factor for type 2 diabetes and cardiovascular disease. However, its relationships with indices of carotid stiffness and plaque volume are unclear. We investigated associations of long-term measurements of BMI with indices of carotid stiffness and atherosclerosis among non-demented diabetes patients from the Israel Diabetes and Cognitive Decline (IDCD) study.MethodsCarotid ultrasound indices [carotid intima media thickness (cIMT), distensibility, elastography and plaque volume] were assessed in N = 471 participants. Mean BMI across all MHS diabetes registry measurements and trajectories of BMI were calculated. BMI was categorized into three trajectory groups representing: a relatively stable normal weight (n = 185, 44%), overweight trajectory (n = 188, 44.8%) and a trajectory of obesity (n = 47, 11.2%). Linear and logistic regressions estimated associations of carotid indices with mean BMI and BMI trajectories.ResultsCompared to the normal weight trajectory, an obesity trajectory was associated with carotid distensibility (β = − 3.078, p = 0.037), cIMT (β = 0.095, p = 0.004), and carotid elastography (β = 0.181, p = 0.004) but not with plaque volume (β = 0.066, p = 0.858). Compared with the normal weight trajectory, an obesity trajectory was associated with increased odds for impaired carotid distensibility (OR = 2.790, p = 0.033), impaired cIMT (OR = 5.277, p = 0.001) and large carotid plaque volume (OR = 8.456, p = 0.013) but not with carotid elastography (OR = 1.956, p = 0.140). Mean BMI was linearly associated with Distensibility (β = − 0.275, p = 0.005) and cIMT (β = 0.005, p = 0.026).ConclusionsLong-term measurements of adiposity are associated with indices of carotid stiffness and plaque volume among older type 2 diabetes adults.
Highlights
MethodsCarotid ultrasound indices [carotid intima media thickness (cIMT), distensibility, elastography and plaque volume] were assessed in N = 471 participants
High body mass index (BMI) is a risk factor for type 2 diabetes and cardiovascular disease
There was no correlation between Carotid Intima Media Thickness (cIMT) with distensibility (ρ2 = − 0.01, p = 0.848) or elastography (ρ2 = − 0.043, p = 0.396)
Summary
Study population The IDCD study investigates the effects of long-term type 2 diabetes-related characteristics on cognitive decline and the study design has been previously described in detail [15]. The cross-sectional arterial wall distensibility coefficient was calculated according to the following equation: Carotid Elastography In the B-mode display, a midsection of straight CCA in longitudinal plane is chosen. On a representative static image, the relative strain ratio (SR), between blood to carotid arterial wall were measured. SR was calculated automatically by dividing strain value of the blood by that of carotid arterial wall, using the QLAB software. The outcomes (cIMT, distensibility coefficient and elastography strain ratio) were defined as the average of the measurements in the right and the left CCA. Linear regression was used to estimate the association (β) and 95% confidence interval (CI) between the outcomes and mean BMI as a continuous dependent variable or BMI trajectory group. The output of PROC TRAJ includes the equations for the different trajectories along with the assignment of each patient to one of the trajectory groups
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