The prevalence and risk factors of carotid artery stenosis in type 2 diabetic patients

Abstract

Background and aim: Patients with type 2 diabetes (T2D) and carotid artery stenosis have an extreme high risk for ischemic stroke, cardiovascular and all-cause death. Our study aimed to determine the prevalence and risk factors for carotid stenosis development in T2D patients. Materials and Methods: Three hundred and eighty-nine patients with T2D were examined. Duplex ultrasound investigation of the extracranial carotid arteries was performed and the carotid intima-media thickness from both sides (CIMT) was determined. A study of serum concentrations of NO, calponin-1, relaxin, and L-citrulline was performed in 152 patients. Results: The signs of carotid arteriosclerosis were revealed in 335 patients (86%). One hundred and thirty-two patients (33.9%) had carotid stenosis of varying degree. The patients with carotid artery stenosis (group 2, n = 132), as compared to those without (group 1, n = 203) were older and had a large waist circumference, a longer diabetes duration, higher urinary albumin/creatinine ratio, and lower estimated glomerular filtration rate (eGFR), all p<; 0.05. In group 2, NO and citrulline concentrations were significantly higher than in group 1 (p=0.005 and p=0.003 respectively). According to ROC analysis, the age ≥65 years, T2D duration ≥15 years and high serum NO concentration were determined as the risk factors for carotid stenosis. The decrease in eGFR <; 60 ml/min*1.73 m <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> , diabetic retinopathy and previous myocardial infarction increased the risk of artery stenosis also (OR 2.24; p=0.0006, OR 1.88; p=0.006, and OR 2.64; p=0.002, respectively). Conclusions: In our cohort of T2D patients, the prevalence of carotid artery stenosis is found to be 33.9%. The presence of carotid stenosis is associated with diabetic retinopathy, reduced renal function, peripheral arterial disease, coronary artery disease and myocardial infarction in anamnesis. Age, diabetes duration, and high serum NO levels are the most reliable risk factors for carotid stenosis in T2D patients.