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Increased carotid intimal media thickness precedes albuminuria in South Indian type 2 diabetic subjects
Vijay Viswanathan
Diabetes Research Centre, No. 4, Main Road, Royapuram, Madras - 600 013, India, dr_vijay{at}vsnl.com
Chamukuttan Snehalatha
Rangamoorthy Suresh Mohan
Diabetes Research Centre, No. 4, Main Road, Royapuram, Madras - 600 013, India
Balakrishnan Mamtha Nair
Diabetes Research Centre, No. 4, Main Road, Royapuram, Madras - 600 013, India
Ambady Ramachandran
Diabetes Research Centre, No. 4, Main Road, Royapuram, Madras - 600 013, India
Introduction Intimal media thickness (IMT) of common carotid artery (CCA) is used as an index of atherosclerosis. IMT is increased in subjects with diabetes and also with diabetic nephropathy.
Aim The study was undertaken in South Indian type 2 diabetic patients with different degrees of albuminuria to see whether albuminuria worsened IMT.
Material and methods IMT was measured by ultrasonography in 273 diabetic subjects with normoalbuminuria (n=91), microalbuminuria (n=92), clinical proteinuria (Prot) (n=90) and in age-matched non-diabetic subjects (n=99). The diabetic subjects were older than the non-diabetic subjects hence IMT was age-adjusted using a linear regression formula.
Results Age-adjusted IMT value in diabetic subjects was significantly higher (0.88±0.3 mm) than in non-diabetic subjects (0.57±0.34 mm) (p<0.001). Mean IMT in normoalbuminuria (0.87±0.26 mm), microalbuminuria (0.90± 0.33 mm) and Prot (0.86±0.39 mm) patients were not significantly different from each other. Male gender, age, diabetes and total cholesterol were independently associated with IMT, while duration of diabetes, hypertension and HbA1C were not.
Conclusion Increased carotid IMT occurred in type 2 diabetes prior to the presence of albuminuria. Further deterioration in IMT did not occur with the presence of albuminuria.
Key Words: atherosclerosis carotid intimal media thickness diabetes diabetic nephropathy.
References
- Garcia MJ, McNamara PM, Gordon T., Kannell WB Morbidity and mortality in diabetics in the Framingham population: Sixteen-year follow-up study. Diabetes 1974;23:105-11.[Web of Science][Medline]
[Order article via Infotrieve]
- Santen RJ, Willis PW, Fajans SS Atherosclerosis in diabetes mellitus correlations with serum lipid levels adiposity and serum insulin level. Arch Intern Med 1972;130:833-43.[Abstract/Free Full Text]
- Chan A., Beach KW, Martin DC, Strandness DE Carotid artery disease in non-insulin dependent diabetes mellitus. Diabetes Care 1983;6:562-9.[Abstract]
- Pignoli P. Ultrasound B-mode imaging for arterial wall thickness measurement. Atheroscler Rev 1984;12:177-84.
- Kawamori R., Yamasaki Y., Matsushima H. Prevalence of Carotid atherosclerosis in diabetic patients. Diabetes Care 1992;15:1290-4.[Abstract]
- Grobbee DE, Bots ML Carotid artery intima - media thickness as an indicator of generalized atherosclerosis. J Intern Med 1994;236:567-73.[Web of Science][Medline]
[Order article via Infotrieve]
- Agewall S., Wikstrand J., Ljungman S., Fagerberg B. Urinary albumin excretion is associated with the intima-media thickness of the carotid artery in hypertensive males with non-insulin-dependent diabetes mellitus. J Hypertens 1995;13:463-9.[Web of Science][Medline]
[Order article via Infotrieve]
- Willey KA, Kidd JF, Harris JP, Xu ZR, Yue DK Albuminuria is an independent predictor of carotid intima-media thickness and atherosclerosis in NIDDM patients. Diabetes Care 1995;18:1502-03.[Web of Science][Medline]
[Order article via Infotrieve]
- Ramachandran A., Snehalatha C., Latha E., Vijay V., Viswanathan M. Rising prevalence of NIDDM in urban population in India. Diabetologia 1997; 40:232-7.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Heart Outcomes Prevention Evaluation Study Investigators. Lancet 2000;355:253-9.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Mohan V., Ravikumar R., Shanthi Rani S., Deepa R. Intimal medial thickness of the carotid artery in South Indian diabetic and non-diabetic subjects: the Chennai urban population study (CUPS). Diabetologia 2000;43:494-9.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Snehalatha C., Ramachandran A., Sathyamurthy I. et al. Association of proinsulin and insulin resistance with coronary artery disease in non-diabetic South Indian men. Diabet Med 2001;18:706-08.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Snehalatha C., Ramachandran A., Satyavani K., Vijay V., Haffner SM Specific insulin and proinsulin concentration in non-diabetic South Indians. Metabolism 1998;47:230-3.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Tominaga M., Eguchi H., Manaka H. et al. Impaired glucose tolerance is a risk factor for cardiovascular disease but not impaired fasting glucose. Diabetes Care 1999;22:920-24.[Abstract]
- Snehalatha C., Satyavani K., Sivasankari S., Vijay V., Ramachandran A. Insulin secretion and action in different stages of glucose in tolerance in Asian Indians. Diabet Med 1999;16:408-14.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 2,
146-149 (2003)
DOI: 10.1177/14746514030030021201

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