The prevalence and risk factors of carotid artery stenosis in type 2 diabetic patients.

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Elena Koroleva1, Rustam Khapaev2, Alexandr Lykov3, Vadim Klimontov4
1Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, ekoro@bk.ru
2Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, khapaevrs@bionet.nsc.ru
3Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, aplykov2@mail.ru
4Research Institute of Clinical and Experimental Lymphology – Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, klimontov@mail.ru

Abstract

Background and aim: Diabetic patients with carotid artery stenosis have an exceptional high risk for all-cause and cardiovascular death. This study aimed to determine the prevalence and risk factors of carotid stenosis in patients with type 2 diabetes (T2D).

Materials and Methods: 390 patients with T2D were examined. Duplex ultrasound of the extracranial carotid arteries was performed and the intima-media thickness of the common carotid arteries (IMT) was determined. A study of serum concentrations of NO, calponin-1, relaxin, and L-citrulline was performed in 152 patients.

Results: the signs of carotid arteriosclerosis were revealed in 338 patients (86%). 134 patients (33%) had carotid stenosis. The patients with carotid artery stenosis (group 2, n = 134), as compared to those without (group 1, n = 204) were older, had a larger waist circumference, a longer diabetes duration, higher urinary albumin/creatinine ratio, and lower eGFR, all p<0.05. There were no differences in sex distribution, smoking rate and other laboratory parameters between the groups. In group 2 NO and citrulline concentrations were significantly higher than in group 1 (p=0.005 and p=0.003 respectively). According to ROC analysis, the age ≥65 years, T2D duration ≥15 years and high serum NO concentration were determined as the risk factors for carotid stenosis. The decrease in eGFR <60 ml/min*1.73 m2, diabetic retinopathy, myocardial infarction in medical history increased the risk of stenosis (HR 2.24; p=0.0006, HR 1.88; p=0.006, and HR 2.64; p=0.002, respectively).

Conclusions: the study shows a high prevalence of carotid artery stenosis in patients with T2D. The age ≥65 years, T2D duration ≥15 years, GFR <60 ml/min*1.73 m2, diabetic retinopathy and myocardial infarction are risk factors for the carotid artery stenosis in patients with T2D.

 

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Vadim Nimaev
Vadim Nimaev
3 years ago

It is very interesting topic. How many patients had a stenosis more than 70% and need surgical treatment? Thank you

Elena Koroleva
Elena Koroleva
3 years ago
Reply to  Vadim Nimaev

In qur cohort 29 patients had hemodynamically significant stenosis. Single patients needed surgical treatment.

Shumkov Oleg
Shumkov Oleg
3 years ago

Dear authors, thanks for the presentation. I wonder if there is a correlation between the development of carotid stenosis in patients with diabetes mellitus and atherosclerosis of the main arteries of the legs?

Elena Koroleva
Elena Koroleva
3 years ago
Reply to  Shumkov Oleg

47% of patients underwent ultrasound examination of the lower extremities arteries. Atherosclerosis of both carotid and arteries of the lower limbs was revealed in 68%. In 16% cases there was only carotid atherosclerosis, in 8%, isolated atherosclerosis of the lower limbs.

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