The Thickness of Carotid Artery Intima-Media Thickness in Hypertriglyceridemic Hyperapo B Type 2 Diabetes

Lee, Ji Hyun; Chung, Duck Soo

Abstract

BACKGROUND: Atherosclerotic diseases such as cardiovascular disease and cerebrovascular disease are major causes of diabetes mellitus-related morbidity and mortality. The frequency of macrovascular disease in type 2 diabetic patients varies geographically, and this suggests that factors other than diabetes play an important role in the pathogenesis of their vascular disease. One such factor may be the dyslipoproteinemias that are common in diabetic patients. There were many studies showing that hypertriglyceridemia with an elevated apolipoprotein B (apo B) level was associated with an increased risk for coronary disease in type 2 diabetes patients. Meanwhile, an increase in the intima-media thickness (IMT) of the carotid artery has been previously reported in patients with type 2 diabetes, and this is related to the atherosclerotic risk factors. The aim of this study was to evaluate the relationship between the carotid artery IMT and lipoprotein and apolipoprotein, and we also wanted to assess the role of hypertriglyceridemic hyperapo B for the cardiovascular risk factors in the type 2 diabetic patients.
METHODS
The carotid artery IMT was measured using high resolution B-mode ultrasono graphy in 117 type 2 diabetes. At the same time, we analyzed the patients characteristics including height, weight, body mass index, blood pressure, duration of diabetes and history of hypertension. Laboratory parameters such as fasting blood glucose, HbA1c, total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol, apolipoprotein A and B were included in this study. We defined hypertrigl yceridemic hyperapo B as when the triglyceride level was over 1.7 mmol/L and the apolipoprotein B level was over 1.20 g/L.
RESULTS
Thirty-three patients (28%) were classified as having hypertriglyceridemic hyperapo B. Age (r = 348, P = 0.001), duration of diabetes (r = 0.438, P = 0.001), hypertension (P = 0.001), and LDL-cholesterol (r = 0.225, P = 0.018) were statistically significant for the carotid artery IMT values in diabetic patients. However, there were no correlations between carotid artery IMT and total cholesterol, triglyceride, HDL- cholesterol, and apolipoprotein A and B. Upon multiple regression analysis, age, duration of diabetes and LDL-cholesterol were statistically significant for the carotid artery IMT values in diabetic patients (R2 = 0.296). Hypertriglyceridemic hyperapo B diabetic patients didn't have higher carotid artery IMT values than the other patients.
CONCLUSION
The increment of carotid artery IMT is affected by age, blood pressure, duration of diabetes and LDL-cholesterol. However, our study did not show any association between carotid artery IMT and hypertriglyceridemic hyperapo B