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OBJECTIVEWe examined the relationship between intima-media thickness of common carotid artery (CCA-IMT) and silent cerebral infarction (SCI) with the magnetic resonance imaging (MRI) study in Japanese subjects with type 2 diabetes.RESEARCH DESIGN AND METHODSThe brain MRI study and the carotid ultrasonography were performed in a total of 217 consecutive Japanese subjects with type 2 diabetes. Various risk factors for SCI were examined using multiple logistic analyses.RESULTSThe SCI was found in 60.4% of the diabetic subjects. In the diabetic subjects, age, systolic blood pressure (SBP), pulse wave velocity, and CCA-IMT were significantly higher in the subjects with SCI than in those without it. Multiple logistic analyses indicated that age, SBP, and CCA-IMT were significant and independent risk factors of SCI in the diabetic subjects.CONCLUSIONSCCA-IMT, but not pulse wave velocity, was independently associated with SCI in Japanese subjects with type 2 diabetes.

Peripheral Arterial Compliance Differs Between Races Comparison among Asian, Afro-Caribbeans, and white Caucasians with type 2 diabetes P atients with type 2 diabetes have two to three times the risk of dying prematurely from cardiovascular disease than their nondiabetic counterparts (1). Many studies have shown that arterial compliance is reduced in type 2 diabetes and that arterial stiffness increases with deteriorating glucose tolerance status, even before the onset of type 2 diabetes (2-4). In a previous brief report, we studied Afro-Caribbean and white Caucasian subjects with diabetes and found a decrease in peripheral arterial compliance in the Afro-Caribbean subjects (5). We also reported an accelerated rate of aging in the elastic arteries of diabetic patients reaching a plateau by the age of 50-60 years (6). The present article examines the control versus diabetic differences in two races, white Caucasians and Afro-Caribbeans, and includes data on Asians from the Indian subcontinent with diabetes. Fifty-seven patients with a diagnosis of type 2 diabetes for at least 1 year (21 white Caucasian, 20 Afro-Caribbean, and 16 Asian) aged 44-80 years (mean Ϯ SD 61 Ϯ 7.4) and 48 healthy control subjects (30 white Caucasian and 18 Afro-Caribbean) aged 34-86 years (65.5 Ϯ 11.6) took part in this cross-sectional study. Pulse wave velocity of the carotidfemoral (PWV cf) was measured noninvasively in a thoraco-abdominal segment and in an upper-limb muscular artery (PWV of the carotid-radial [PWV cr ]) using the Complior (Colson, Pantin, France) system. PWV from the aorta to the finger (PWV fin) was measured using the Finapress (Ohmeda, Madison, WI) and custom-written software (J.D.C.). Central aortic compliance (CAC) was also assessed from simultaneous measurements of ascending aortic blood flow and surrogate estimates of aortic root pressure using a method described by Liu et al. (7) and previously reported by Cameron et al. (8). Analysis of the clinical characteristics of the participants for the diabetic and control groups and by ethnicity showed that for the diabetic group, only BMI was significantly different between the races (P Ͻ 0.05), with the white patient group having the highest mean value (29.9 kg/ m 2). For the control population, only age was significantly different (P ϭ 0.01), with Caucasians being on average 8 years older than Afro-Caribbeans. Race was found to be a major determinant of PWV cr in type 2 diabetic subjects, with Afro-Caribbeans having the highest mean value (12.10 Ϯ 1.4 m/s) of the three ethnic origins (P ϭ 0.03) compared with Caucasians (11.12 Ϯ 1.3 m/s) and Asians (10.95 Ϯ 1.3 m/s). The racial differences were independent of blood pressure. No differences were found between the races for PWV cf , PWV fin , or CAC. Analysis in the control population showed no differences in arterial compliance between the Afro-Caribbeans and Caucasians. We have shown that there is a racial preponderance of stiffening of the peripheral arteries in diabetic subjects, with subjects of Afro-Caribbean origi...

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