Carotid Atherosclerosis in Diabetic Patients and Associated Risk Factors
DOI:
https://doi.org/10.51253/pafmj.v74i5.9234Keywords:
Atherosclerosis, Carotid Doppler, Diabetes MellitusAbstract
Objective: To determine the frequency of carotid atherosclerosis in diabetic patients and find out its association with various risk factors.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Medicine, Combined Military Hospital, Nowshera Pakistan, from May to Jul 2022.
Methodology: Patients, from both genders, were included in this study. Demographic information was obtained from all patients. Patients fulfilling the inclusion and exclusion criteria underwent carotid Doppler ultrasound after giving informed consent. High-resolution 7.5 MHz probe B mode ultrasonography and atherosclerosis was classified on the basis of grey-scale imaging.
Results: A total of 100 patients were included in the study, out of which 74 were males and 26 were females. Among diabetics, 54% occurrence of atherosclerosis was seen, with a major share of 24% involvement of the left carotid artery, followed by 18% bilaterally, and 12% right carotid artery involvement. Carotid intimal media thickness increased with advancing age, with variable severity of mild in 32%, moderate in 14%, and severe stenosis in 3% of positive cases.
Conclusion: There was a high association of carotid atherosclerosis with diabetes mellitus, having significant association with older age, hypertension, hyperlipidemia, and smoking.
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References
Coelho AP, Lobo M, Nogueira C, Gouveia R, Campos J, Augusto R, et al. Overview of evidence on risk factors and early management of acute carotid stent thrombosis during the last two decades. J Vasc Surg 2019; 69(3): 952-964. https://doi.org/10.1016/j.jvs.2018.08.175
Hu X, Li W, Wang C, Zhang H, Lu H, Li G, et al. Association between the plasma-glycosylated hemoglobin A1c/high-density lipoprotein cholesterol ratio and carotid atherosclerosis: a retrospective study. J Diabetes Res 2021; 2021: 9238566. https://doi.org/10.1155/2021/9238566
Murray CSG, Nahar T, Kalashyan H, Becher H, Nanda NC. Ultrasound assessment of carotid arteries: current concepts, methodologies, diagnostic criteria, and technological advancements. Echocardiography 2018; 35(12): 2079-2091.
https://doi.org/10.1111/echo.14167
Zhu G, Hom J, Li Y, Jiang B, Rodriguez F, Fleischmann D, et al. Carotid plaque imaging and the risk of atherosclerotic cardiovascular disease. Cardiovasc Diagn Ther 2020; 10(4): 1048-1067. https://doi.org/10.21037/cdt.2020.03.08
Varennes L, Tahon F, Kastler A. Fibromuscular dysplasia: what the radiologist should know: a pictorial review. Insights Imaging 2015; 6(3): 295-307.
https://doi.org/10.1007/s13244-015-0408-4
Doonan RJ, Abdullah A, Steinmetz-Wood S, Mekhaiel S, Steinmetz OK, Obrand DI, et al. Carotid endarterectomy outcomes in the elderly: a Canadian institutional experience. Ann Vasc Surg 2019; 59: 16-20.
https://doi.org/10.1016/j.avsg.2019.01.015
Morales MM, Anacleto A, Filho CM, Ledesma S, Aldrovani M, Wolosker N. Peak systolic velocity for calcified plaques fails to estimate carotid stenosis degree. Ann Vasc Surg 2019; 59: 1-4. https://doi.org/10.1016/j.avsg.2019.02.030
Xu X, Hua Y, Liu B, Zhou F, Wang L, Hou W. Correlation between calcification characteristics of carotid atherosclerotic plaque and plaque vulnerability. Ther Clin Risk Manag 2021; 17: 679-690.
https://doi.org/10.2147/TCRM.S313809
Fernández-Alvarez V, Linares Sánchez M, López Alvarez F, Suárez Nieto C, Mäkitie AA, Olsen KD, et al. Evaluation of intima-media thickness and arterial stiffness as early ultrasound biomarkers of carotid artery atherosclerosis. Cardiol Ther 2022; 11(2): 231-247.
https://doi.org/10.1007/s40119-021-00250-1
Dossabhoy S, Arya S. Epidemiology of atherosclerotic carotid artery disease. Semin Vasc Surg 2021; 34(1): 3-9.
https://doi.org/10.1053/j.semvascsurg.2021.01.003
Song P, Wang H, Cai Y, Rahimi K, Zhu Y. Global and regional prevalence, burden and risk factors for carotid atherosclerosis, a systemic review. Meta-analysis and modeling study. Lancet Glob Health 2020; 8: 721-729.
https://doi.org/10.1016/S2214-109X(20)30078-0
Wu TW, Chou CL, Cheng CF, Lu SX, Wang LY. Prevalences of diabetes mellitus and carotid atherosclerosis and their relationships in middle-aged adults and elders: a community-based study. J Formos Med Assoc 2022; 121(6): 1133-1140. https://doi.org/10.1016/j.jfma.2021.11.007
Chou CL, Wu YJ, Hung CL, Liu CC, Wang SD, Wu TW. Segment-specific prevalence of carotid artery plaque and stenosis in middle-aged adults and elders in Taiwan: a community-based study. J Formos Med Assoc 2019; 118: 64-71. https://doi.org/10.1016/j.jfma.2018.01.010
Wu TW, Hung CL, Liu CC, Wu YJ, Wang LY, Yeh HI. Associations of cardiovascular risk factors with carotid intima-media thickness in middle-age adults and elders. J Atheroscler Thromb 2017; 24(7): 677-686.
https://doi.org/10.5551/jat.36783
Wu Y, Liu F, Adi D, Yang YN, Xie X, Li XM, et al. Association between carotid atherosclerosis and different subtypes of hypertension in adult populations: a multiethnic study in Xinjiang, China. PLoS One 2017; 12(2): e0171791. https://doi.org/10.1371/journal.pone.0171791
Noh M, Kwon H, Jung CH. Impact of diabetes duration and degree of carotid artery stenosis on major adverse cardiovascular events: a single-center, retrospective, observational cohort study. Cardiovasc Diabetol 2017; 16: 74. https://doi.org/10.1186/s12933-017-0556-0
Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 2020; 41: 255-323.
https://doi.org/10.1093/eurheartj/ehz486
Selwaness M, van den Bouwhuijsen Q, van Onkelen RS, Hofman A, Franco OH, van der Lugt A, et al. Atherosclerotic plaque in the left carotid artery is more vulnerable than in the right. Stroke 2014; 45(11): 3226-3230.
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Copyright (c) 2024 Muhammad Farooq, Majida Farooq, Naila Mumtaz, Amna Saleem, Aqib Ali Shah
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