The Correlation Between Femoral Artery Intima-Media Thickness (IMT) and Atherosclerotic Risk Factors in Type 2 Diabetes Mellitus Patients

Lee, Ji Hyun; Shon, Ho Sang; Chung, Duck Soo

Abstract

BACKGROUND: High resolution B-Mode ultrasound is increasingly used in epidemiological and clinical research to noninvasively study the atherosclerotic process in the carotid artery. An increase in the intimamedia thickness (IMT) of the carotid artery has previously been reported in patients with diabetes, compared with a control group, and is related to atherosclerotic risk factors. There have been few reports on the relationship between the IMT of the femoral artery, another large artery, and atherosclerotic risk factors in diabetic patients. The aim of the present investigation was to evaluate the relationship between the femoral artery IMT and the atherosclerotic risk factors in type 2 diabetics, and to assess if such a measurement might provide further information on the extent of the atherosclerotic disease in these patients. METHODS: The carotid and femoral IMT were measured using high resolution B-mode ultrasonography in 55 type 2 diabetes patients and 25 age- and sex-matched control subjects. The femoral artery was examined distal to the inguinal ligament, at the site the artery divides into the superficial femoral and the profound femoral arteries. At the same time, patient's characteristics, including height, weight, body mass index, blood pressure, duration of diabetes and histories of hypertension and smoking, were analyzed. Examinations of the laboratory parameters, such as serum glucose, HbA1C, lipid profile, blood urea nitrogen and serum creatinine, were included in this study. RESULTS: The carotid and femoral IMT values were significantly increased in the type 2 diabetes patients compared with the control subjects. There was a significant relationship between the IMT values of the two arteries in the diabetic patients (r=0.419, p< 0.001). In a simple regression analysis, age (r=0.534, p=0.001), systolic blood pressure (r=0.499, p=0.001), diastolic blood pressure (r=0.350, p=0.003), high density lipoprotein cholesterol (r=-0.262, p=0.037) and the serum creatinine level (r=0.280, p=0.020) were statistically significant for the femoral artery IMT value. In a multiple regression analysis, age, smoking and systolic blood pressure were statistically significant for the femoral artery IMT values in diabetic patients (R2=0.379). CONCLUSION: The femoral IMT values were significantly increased in the type 2 diabetes patients. Increases in the IMT of the femoral artery are affected by the atherosclerotic risk factors; age, smoking and blood pressure. Therefore, it is suggest that measurement of the femoral IMT, using high resolution B-mode ultrasonography, is also a useful method for the detection of macrovascular complications in type 2 diabetes patients.