Stenotic atherosclerotic lesions of carotid arteries in type 2 diabetes: the most significant risk factors

Abstract

Significant prevalence of atherosclerosis and its complications in patients with type 2 diabetes (T2D) determines need in further investigations of existing risk factors (RF).Study object: to identify the most significant RF for the carotid stenotic lesions development in T2D patients.Materials and methods. The correlation analysis between surrogate atherosclerosis markers (carotid intima-media thickness (IMT), atherosclerotic plaques (AP), degree of the carotid stenosis) and mean systolic blood pressure (SBP), body mass index (BMI), anxiety index (from Hospital anxiety and depression rating scale (HADRS)); mean serum level of lipids, HbA1c, high sensitivity C-reactive protein (hsCRP), uric acid (UA) during 5 years observation in 145 patients with T2D (mean age – 53,0 (49,0–60,5) years) was done. Statistical analysis was performed using IBM SPSS Statistics 20.Results. Direct medium-strength correlations between IMT and mean SBP (r=0,38), mean levels of hsCRP (r=0,41), UA (r=0,40), HbA1c (r=0,44), total cholesterol (TC) (r=0,40), low-density lipoprotein cholesterol (LDL-C) (r=0,41), anxiety index (r=0,40) were found. At the same time the degree of carotid stenosis was also directly correlated with mean levels of hsCRP (r=0,41), HbA1c (r=0,42), TC (r=0,37), LDL-C (r=0,32). The incidence of carotid AP was increased in 3 fold in patients with mean hsCRP>3,0 mg/L (χ2 (1)=29,9, φ=0,454; RR:3,62; 95% CI:1,91–6,84), 2 fold – in patients with mean HbA1c>8,5% (χ2 (1)=7,9, φ=0,259; RR:2,50; 95% CI:1,13–2,98) and TC>4,5 mmol/L (χ2 (1)=9,3, φ=0,253; RR:2,51; 95% CI:1,15–5,46); in 1,5 fold – in patients with mean LDL-C>2,6 mmol/L (χ2 (1)=4,3, φ=0,272; RR:1,67; 95% CI:1,0–2.99).Conclusion. The most significant RF for the stenotic carotid atherosclerotic lesions development in patients with T2D are hsCRP>3,0 mg/L, HbA1c>8,5%, TC>4,5 mmol/L, LDL-C>2,6 mmol/L, UA>300 μmol/L, SBP>140 mmHg, HADRS score > 11 units and BMI>25 kg/m2.