Coronary Artery Disease and Carotid Artery Intima-Media Thickness in Japanese Type 2 Diabetic Patients

Mitsuhashi, Naoki; Onuma, Tomio; Kubo, Sachiko; Takayanagi, Naoko; Honda, Motoe; Kawamori, Ryuzo

doi:10.2337/diacare.25.8.1308

Cited by 52 publications

(33 citation statements)

References 23 publications

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“…Likewise, carotid IMT has consistently been shown to be greater in type 2 diabetic patients than in non-diabetic subjects [44][45][46]. In addition, IMT has correlated with the presence of CVD in type 2 diabetic patients [47].…”

Section: Discussionmentioning

confidence: 95%

Increased augmentation of central blood pressure is associated with increases in carotid intima–media thickness in type 2 diabetic patients

et al. 2005

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Aims/hypothesis: Type 2 diabetes is associated with a two-to seven-fold increase in cardiovascular morbidity and mortality. The aim of this study was to determine the relationships between intima-media thickness (IMT), an established marker of atherosclerosis, large artery function and other determinants of cardiovascular risk in type 2 diabetic patients. Methods: We studied 228 type 2 diabetic patients (75 women, aged 62±2 years [mean± SEM]). Carotid IMT was bilaterally measured using ultrasound technology. Applanation tonometry and pulse wave analysis were used to measure aortic systolic and diastolic blood pressures, central pressure augmentation (AG) and the augmentation index (AIx), a measure of systemic arterial stiffness. Conventional cardiovascular risk factors (lipids, HbA 1 c, smoking and diabetes duration) were also assessed. Results: Women had higher AG and AIx (p<0.0001), despite comparable systolic BP and heart rate in women and men. In women, AG (r=0.39, p<0.001), age (r=0.32, p<0.01), brachial systolic BP (r=0.34, p< 0.01) and aortic systolic BP (r=0.34, p<0.01) correlated with IMT. In men, age (r=0.41, p<0.001), diabetes duration (r=0.25, p<0.01), AG (r=0.22, p<0.01), aortic systolic BP (r=0.21, p<0.01), brachial systolic BP (r=0.21, p<0.01) and body weight (r=0.16, p<0.05) correlated with IMT. In multiple linear regression analyses, AG and aortic systolic BP, but not brachial systolic BP, were age-independent determinants of IMT in men and women. In all patients, increased AG (adjusted for sex, age and heart rate) correlated with longer duration of diabetes, urinary albumin excretion and IMT. Conclusions/interpretation: Measures of central systolic pressure correlate with carotid IMT, independently of age and other risk markers.

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Section: Discussionmentioning

confidence: 95%

Increased augmentation of central blood pressure is associated with increases in carotid intima–media thickness in type 2 diabetic patients

et al. 2005

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“…The outcome measurement, CIMT is considered to be an appropriate measure for generalised atherosclerosis [32][33][34]. It is strongly related to several cardiovascular risk factors Values are expressed as linear regression coefficients, adjusted for gender and age, with 95% confidence interval in parentheses, and reflect changes in S.D.…”

Section: Discussionmentioning

confidence: 99%

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

et al. 2005

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Background: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a potential confounder. Methods: An observational study was performed in 215 subjects with type 1 diabetes treated with multiple insulin injection therapy. Atherosclerosis was assessed by measurement of carotid intima-media thickness (CIMT). Results: The cumulative dose of regular insulin showed a positive and significant relation with CIMT: increase of 21 m in CIMT per S.D. of insulin use (95% CI: 8-35 adjusted for gender and age), which remained unchanged after adjustment for duration of diabetes, HbA1c, BMI, pulse pressure, physical activity and carotid lumen diameter. A similar relation was found for intermediate-acting insulin: 15.5 m per S.D. (2-29), which was no longer present after further adjustment. Conclusions: These findings provide evidence that a high cumulative dose of regular insulin is a risk factor for atherosclerosis.

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“…It has been reported that the prevalence of CAD in middle-aged and older type 2 diabetic patients is approximately 0.1. It has been also reported that IMT was 1.27 0.07 mm (mean SD) in type 2 patients with CAD diagnosed by coronary angiography and 1.03 0.04 mm in patients without CAD, respectively 28) . Based on these previous findings, in this study, registration of 11 patients or more was required to detect a significant difference between subjects with and without CAD, if it is assumed that the standard deviation common to both groups is 0.07 mm, and -level and power are 5% and 90%, respectively.…”

Section: Sample Size and Statistical Analysesmentioning

confidence: 99%

Association of Coronary Artery Stenosis with Carotid Atherosclerosis in Asymptomatic Type 2 Diabetic Patients

Irie

Sakamoto

Kubo

et al. 2011

JAT

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Aims: Carotid atherosclerosis assessed by ultrasound is an established surrogate marker for systemic atherosclerosis. This study aimed to evaluate the association between coronary artery stenosis assessed by coronary computed tomography angiography (CCTA) and intima-media thickness (IMT) in asymptomatic type 2 diabetic patients. Methods: In a cross-sectional study, carotid IMT was measured by ultrasound and CCTA in 169 asymptomatic type 2 diabetic patients.

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Coronary Artery Disease and Carotid Artery Intima-Media Thickness in Japanese Type 2 Diabetic Patients

Cited by 52 publications

References 23 publications

Increased augmentation of central blood pressure is associated with increases in carotid intima–media thickness in type 2 diabetic patients

Increased augmentation of central blood pressure is associated with increases in carotid intima–media thickness in type 2 diabetic patients

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

Association of Coronary Artery Stenosis with Carotid Atherosclerosis in Asymptomatic Type 2 Diabetic Patients

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