The Relation of Intra-Abdominal Adipose Tissue Accumulation and the Development of Vulnerable Carotid Atherosclerotic Plaques in Diabetes Mellitus.

Abstract

Objective: The aim of study was determining the relation between the quality of metabolic control, anthropometric parameters and ultrasound measurement of fat accumulation and carotid atherosclerotic plaques vulnerability in patients with type 2 diabetes. Methods: The study included 51 patients with type 2 diabetes mellitus and 50 healthy individuals. The assessment of plaque vulnerability relies on quantitative and qualitative plaque ultrasound analysis. The thickness of intraabdominal adipose tissue was measured as a distance between the frontal wall of abdominal aorta and the dorsal wall of rectus abdominis muscles; the measurements are performed by placing transducer 5 cm above the umbilicus. Results: Atherosclerotic plaque was found in all of diabetic patients, comparing to 28.12% in the control group; among those, 47.06% with diabetes and 25.6% of control patients had vulnerable plaque. The vulnerability of atherosclerotic plaque was significantly related to age, duration of diabetes, glycaemia, waist circumference, waist / hip ratio, intra-abdominal adipose tissue thickness, intra-abdominal/subcutaneous fat ratio, dyslipidemia and hypertension. Conclusions: Carotid atherosclerotic plaques, particularly vulnerable ones, are far more prevalent in diabetic patients. Advanced age, poor glycemic control, obesity and the intra-abdominal fat accumulation contribute to carotid atherosclerotic plaques vulnerability. Despite the significant correlations with metabolic/anthropometric measurements, none of the predisposing factors could be identified as the independent risk factor; obviously, the increased vulnerability of has been the result of the synergistic effects of multiple pathogenic mechanisms. Moreover, ultrasound measurements of intra-abdominal fat did not show a decisive advantage over the classical anthropometric measurements in estimating atherosclerotic and metabolic risk.