Abstract
The aim of the study was to investigate ultrasound tissue characterization of carotid plaques in subjects with and without diabetes type 1 (T1D). B-mode carotid ultrasound was performed to assess the presence and type of plaque in a group of 340 subjects with and 304 without T1D, all of them without cardiovascular disease. One hundred and seven patients with T1D (49.5% women; age 54 ± 9.8 years) and 67 control subjects without diabetes who had at least one carotid plaque were included in the study. The proportion of subjects who had only echolucent plaques was reduced in the group of patients with T1D (48.6% vs. 73.1%). In contrast, the proportion with only echogenic (25.2% vs. 7.5%) and calcified plaques (9.4% vs. 1.5%) was increased compared with subjects without diabetes. Moreover, having at least one echogenic plaque was more frequent in T1D patients compared with subjects without diabetes (49.5% vs. 26.9% p = 0.005). In addition to diabetes (OR 2.28; p = 0.026), age (OR 1.06, p = 0.002) was the other variable associated with echogenic plaque existence in multiple regression analysis. Patients with T1D exhibit a differential pattern of carotid plaque type compared with subjects without diabetes, with an increased frequency of echogenic and extensively calcified plaques.
Highlights
Atherosclerotic cardiovascular disease (CV) is a major cause of mortality in patients with type 1 diabetes [1,2]
Patients with type 1 diabetes exhibited reduced waist circumference, diastolic blood pressure, and plasma triglyceride, total cholesterol and low-density lipoprotein (LDL) cholesterol concentrations compared with the non-diabetic group
Patients with type 1 diabetes exhibited increased systolic blood pressure, heart rate, and high-density lipoprotein (HDL) cholesterol concentrations compared with the group of subjects without diabetes (Table 1)
Summary
Atherosclerotic cardiovascular disease (CV) is a major cause of mortality in patients with type 1 diabetes [1,2]. Data regarding atherosclerotic plaques in patients with type 1 diabetes are very scarce In this sense, our group has recently described an increased proportion and burden of carotid plaques in a group of 340 patients with T1D without CV events compared with a group of subjects without diabetes [7]. Plaque echogenicity as assessed by carotid ultrasound reliably predicts the content of soft tissue and the amount of calcification in carotid plaques [8] In this regard, echolucent plaques exhibit more lipid, inflammatory cells and haemorrhage compared with echogenic plaques, which contain more calcification and fibrous tissue; characteristics that have been validated by histopathology [8,9,10]. Vascular calcification beyond coronary arteries (i.e., carotid and aortic plaques) has been described to be associated with all-cause and CV mortality both in patients with [12] and without type 2 diabetes [13]
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