Insulin resistance and carotid atherosclerosis in patients with type 2 diabetes

Park, Seok Won; Kim, Soo‐Kyung; Cho, Yong Wook; Kim, Dae Jung; Song, Young Duk; Choi, Young Ju; Huh, Byung Wook; Choi, Sung Hee; Jee, Sun Ha; Cho, Mi Ae; Lee, Mi Kyung; Huh, Kap Bum

doi:10.1016/j.atherosclerosis.2008.12.006

Cited by 22 publications

(19 citation statements)

References 31 publications

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“…Results in previously published studies on the relationship between IR and early carotid atherosclerotic lesions are equivocal [40,41]. In addition, few studies have examined the possible relation between carotid plaque and IR.…”

Section: Discussionmentioning

confidence: 99%

Association between Cardiac Autonomic Neuropathy, Diabetic Retinopathy and Carotid Atherosclerosis in Patients with Type 2 Diabetes

et al. 2013

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BackgroundIt is not clear whether microangiopathies are associated with subclinical atherosclerosis in type 2 diabetes mellitus (T2DM). We investigated the relation of cardiac autonomic neuropathy (CAN) and other microangiopathies with carotid atherosclerosis in T2DM.MethodsA total of 131 patients with T2DM were stratified by mean carotid intima-media thickness (CIMT) ≥ or <1.0 mm and the number of carotid plaques. CAN was assessed by the five standard cardiovascular reflex tests according to the Ewing's protocol. CAN was defined as the presence of at least two abnormal tests or an autonomic neuropathy points ≥2. Diabetic microangiopathies were assessed.ResultsPatients with CAN comprised 77% of the group with mean CIMT ≥1.0 mm, while they were 29% of the group with CIMT <1.0 mm (P=0.016). Patients with diabetic retinopathy (DR) comprised 68% of the group with CIMT ≥1.0 mm, while they were 28% of the group without CIMT thickening (P=0.003). Patients with CAN comprised 51% of the group with ≥2 carotid plaques, while they were 23% of the group with ≤1 carotid plaque (P=0.014). In multivariable adjusted logistic regression analysis, the patients who presented with CAN showed an odds ratio [OR] of 8.6 (95% confidence interval [CI], 1.6 to 44.8) for CIMT thickening and an OR of 2.9 (95% CI, 1.1 to 7.5) for carotid plaques. Furthermore, patients with DR were 3.8 times (95% CI, 1.4 to 10.2) more likely to have CIMT thickening.ConclusionThese results suggest that CAN is associated with carotid atherosclerosis, represented as CIMT and plaques, independent of the traditional cardiovascular risk factors in T2DM. CAN or DR may be a determinant of subclinical atherosclerosis in T2DM.

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Section: Discussionmentioning

confidence: 99%

Association between Cardiac Autonomic Neuropathy, Diabetic Retinopathy and Carotid Atherosclerosis in Patients with Type 2 Diabetes

et al. 2013

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“…Although the difference in the number of metabolic risks or fasting insulin level did not affect the change in IMT in both groups (data not shown), the beneficial effect of pioglitazone on carotid IMT may be at least partially attributed to the modulation of hyperglycemia and/or dyslipidemia. Another possibility is that pioglitazone may have decreased carotid IMT by improving insulin sensitivity, since insulin resistance is reported to be a risk factor for carotid atherosclerosis 26) . In addition to these metabolic actions, pioglitazone has beneficial effects on endothelial cell function 27) and may have mediated the regression of carotid IMT by improving arterial vasodilator capacity, platelet aggregation, and intimal thickening.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

Yamasaki¹,

Katakami²,

Furukado³

et al. 2010

JAT

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Aim:No previous studies have evaluated the long-term anti-atherosclerotic effects of pioglitazone in Asian patients with type 2 diabetes. Therefore, the present study investigated the protective effects of pioglitazone on the progression of carotid intima-media thickness (IMT), an established surrogate marker of cardiovascular events in Japanese type 2 diabetic patients without a recent history of cardiovascular morbidity. Methods: This 2.5 − 4-year, randomized, open-label, blinded endpoint study was conducted in 6 centers across Japan. Patients received pioglitazone with or without other oral glucose-lowering drugs (excluding another thiazolidinedione) (n 89) or oral glucose-lowering drugs, excluding thiazolidinediones (n 97). Treatment was adjusted to achieve HbA1c 6.5%. The primary endpoints of the study were the absolute changes from the baseline to final visit in max-and mean-IMT in the average of bilateral common carotid arteries.

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“…Using B-mode ultrasound with a 10-MHz linear transducer, the carotid arteries were examined bilaterally at the common carotid artery, the bifurcation, and the internal carotid arteries (ALOKA, SSD-a;10, Tokyo, Japan) (Park et al, 2009). The IMT of carotid arteries was assessed including a focal plaque or diffuse thickening of the carotid wall, and the max-IMT (maximum thickness) was used as a measure of atherosclerosis.…”

Section: B-mode Ultrasonic Carotid Arterial Measurementsmentioning

confidence: 99%

The Correlation between CVR-R and Carotid Atherosclerosis in Type 2 Diabetes Mellitus Patients with Diabetic Neuropathy

Miyamoto

Kotani

Yagyu

et al. 2010

J Physiol Anthropol

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We examined the relationship between the coefficient of variation in the R-R intervals (CVR-R) using electrocardiograms and the ultrasonic intima-media thickness (IMT) of the carotid artery, an atherosclerotic parameter, in type 2 diabetes mellitus (DM) patients with diabetic neuropathy (nϭ47, males/females: 29/18; mean age: 62 years). In this study, the CVR-R-related indexes, including CVR-R at rest (CVR-R rest ), CVR-R with deep breaths (CVR-R breath ) and their difference (CVR-R breath minus CVR-R rest : CVR-R dif ), were defined. Data such as body mass index, smoking habits, hemoglobin A1c, blood pressure, and serum low-density lipoprotein were collected. A significant inverse correlation was observed between max-IMT and CVR-R dif (b ϭ-0.34, pϭ0.042), but not CVR-R rest or CVR-R breath , in multivariate analyses adjusted for all the data. Therefore, the CVR-R dif may serve as a clinical index for the diabetic autonomic neuropathy-atherosclerosis relation in type 2 DM patients.

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Insulin resistance and carotid atherosclerosis in patients with type 2 diabetes

Cited by 22 publications

References 31 publications

Association between Cardiac Autonomic Neuropathy, Diabetic Retinopathy and Carotid Atherosclerosis in Patients with Type 2 Diabetes

Association between Cardiac Autonomic Neuropathy, Diabetic Retinopathy and Carotid Atherosclerosis in Patients with Type 2 Diabetes

Long-Term Effects of Pioglitazone on Carotid Atherosclerosis in Japanese Patients with Type 2 Diabetes without a Recent History of Macrovascular Morbidity

The Correlation between CVR-R and Carotid Atherosclerosis in Type 2 Diabetes Mellitus Patients with Diabetic Neuropathy

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