Asymptomatic Carotid Artery Stenosis among Patients with Type II Diabetes Mellitus

Authors

  • Sadia Shahid
  • Abdul Latif Khattak
  • Karamat Hussain Shah Bukhari
  • Raffi Uddin
  • Raees Iqbal Khan

DOI:

https://doi.org/10.51985/AITH5490

Keywords:

Asymptomatic, Carotid artery intima-media thickness, Type 2 diabetes

Abstract

Objectives: To assess Carotid artery intima-media thickness in patients with type II diabetes mellitus.
Study design and setting: This descriptive cross-sectional study was conducted at Department of Medicine, CMH Quetta
from June 2018 to May 2019.
Methodology: Total 176 known type II diabetes mellitus (DM) patients were included in study. Age ranged from 30-70
years. Patients using statin drugs, chronic kidney disease and decompensated liver cirrhosis were excluded. Carotid artery
ultrasonography was carried out by radiologist. Carotid artery intima-media thickness (CIMT) was achieved with a 7 MHz
B-mode ultrasound system. The intima-media thickness (IMT) was demarcated as the distance between the leading edge
of the luminal echo to the leading edge of the adventitia of the media. This distance was measured during the diastolic
phase. This was measured 3 cm before the carotid bifurcation. Also, carotid bifurcation and internal carotid artery 2 cm
distally from the carotid bifurcation was scanned.
Results: Mean age was 47.86 ± 6.46 years. Most of the patients 125 (71.02%) were consisted of 30 to 50 years of age.
Among them the 176 patients, 92 (52.27%) were male and 84 (47.73%) were females. Male to female ratio comprised of
1.1:1. Results further revealed that 43(24.43%) patients showed asymptomatic Carotid artery intima-media thickness. Rest
there was no asymptomatic Carotid artery intima-media thickness in 133 (75.57%) patients

References

Shoback, Gardner DG, Dolores. Greenspan's basic & clinical endocrinology. 9th ed. New York: McGraw-Hill Medical. 2011; Chap 17.

Khanzada MA, Siyal NA, Mirza SA, Memon A, El-Muttaqi A, Mirza AA. Frequency and types of diabetic maculopathy in type II diabetes. Pak J Surg. 2013;29(2):139-42.

Vijan S. Type 2 diabetes. Ann Intl Med. 2010;152(5):31–15.

Ludwig J, Sanbonmatsu L, Gennetian L, Adam E, Duncan GJ, Katz LF, et al. Neighborhoods, obesity, and diabetes--a randomized social experiment. N Engl J Med. 2011;365(16):1509-19.

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2012;55(6):1577-96.

Park BJ, Shim JY, Lee HR, Jung DH, Lee JH, Lee YJ. The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences. Platelets. 2012;23(1):45-50.

DW, PZ, TA, MP, AJ, RA. The Rising Prevalence of Diabetes and Impaired Glucose Tolerance. Diabetes Care 2012;25(5):829-834.

Leong A, Porneala B, Dupuis J, Florez JC, Meigs JB. Type 2 diabetes genetic predisposition, obesity, and all-cause mortality risk in the US: a multiethnic analysis. Diabetes care. 2016;39(4):539-46.

Zimmet PZ, Alberti KG. Epidemiology of diabetes—status of a pandemic and issues around metabolic surgery. Diabetes care. 2016;39(6):878-83.

Kakisis JD, Avgerinos ED, Antonopoulos CN, Giannakopoulos TG, Moulakakis K, Liapis CD. The European Society for Vascular Surgery guidelines for carotid intervention: an updated independent assessment and literature review. Eur J VascEndovasc Surg. 2012;44:238–243.

den Hartog AG, Achterberg S, Moll FL, Kappelle LJ, Visseren FL, van der Graaf Y, et al. Asymptomatic carotid artery stenosis and the risk of ischemic stroke according to subtype in patients with clinical manifest arterial disease. Stroke 2013;44(4):1002-7.

J, K, S, KM. Measurement of intima media thickness of carotid artery by B-mode ultrasound in healthy people of India and Bangladesh, and relation of age and sex with carotid artery intima media thickness: An observational study. J Cardiovasc Dis Res. 2012;3(2):128–131.

Taneja S, Chauhan S, Kapoor PM, Jagia P, Bisoi AK. Prevalence of carotid artery stenosis in neurologically asymptomatic patients undergoing coronary artery bypass grafting for coronary artery disease: Role of anesthesiologist in preoperative assessment and intraoperative management. Annals of cardiac anaesthesia. 2016; 19(1):76.

Cardoso CR, Salles GC, Leite NC, Salles GF. Prognostic impact of carotid intima-media thickness and carotid plaques on the development of micro-and macrovascular complications in individuals with type 2 diabetes: the Rio de Janeiro type 2 diabetes cohort study. Cardiovascular Diabetology. 2019;18(1):2.

Zhang M, Wen X, Zhou C, Huang J, He Y. Carotid intima-media thickness and plaques in internal carotid artery as surrogate markers of lower limb arterial lesions in Chinese patients with diabetic foot. Brazilian Journal of Medical and Biological Research. 2019;52(7).

Matthias W. Lorenz, Jackie F. Price, Christine Robertson, Michiel L. Bots, Joseph F. Polak, Holger Poppert et.alCarotid Intima-Media Thickness Progression and Risk of Vascular Events in People with Diabetes: Results From the PROG-IMT Collaboration.. 2015; 38: 1921–1929.

Yang B, Li TD, Wang JS, Zhi G, Jin WS, Xu Y. Insulin resistance and carotid atherosclerosis in 221 patients with potential hyperglycemia. Chin Med Sci J. 2005;20(2):108–111.

Horner S, Augustin M, Schmidt R, Fazekas F, Ott E, Niederkorn K. Long-term transcranial Doppler sonography and magnetic resonance imaging for evaluation of silent cerebral embolism in cerebrovascular asymptomatic probands. Turk SerebrovaskulerHastaliklarDergisi2005;11:9-12.

Langsfeld M, Lusby RJ. The spectrum of carotid artery disease in asymptomatic patients. J Cardiovasc Surg 1988;29:687-91.

Mineva PP, Manchev IC, Hadjiev DI. Prevalence and outcome of asymptomatic carotid stenosis: A population-based ultrasonographic study. Eur J Neurol 2002;9:383-8.

Su TC, Jeng JS, Chien KL, Sung FC, Hsu HC, Lee YT. Hypertension status is the major determinant of carotid atherosclerosis: A community-based study in Taiwan. Stroke 2001;32:2265-71.

Josse MO, Touboul PJ, Mas JL, Laplane D, Bousser MG. Prevalence of asymptomatic internal carotid artery stenosis. Neuroepidemiology 1987;6:150-2.

van Merode T, Hick P, Hoeks PG, Reneman RS. Serum HDL/total cholesterol ratio and blood pressure in asymptomatic atherosclerotic lesions of the cervical carotid arteries in men. Stroke 1985;16:34-8.

Willeit J, Kiechl S. Prevalence and risk factors of asymptomatic extracranial carotid artery atherosclerosis. A population-based study. ArteriosclerThromb1993; 13:661-8.

Pujia A, Rubba P, Spencer MP. Prevalence of extracranial carotid artery disease detectable by echo-Doppler in an elderly population. Stroke 1992; 23:818-22.

Peigang Tian, Xiangyang Zheng, Mingzhi Li, Weiwei Li, QingliangNiu. Long-term prognostic value of coronary computed tomography angiography for asymptomatic patients with CAD in type 2 diabetes mellitus. . 2019; 18: 747–754.

10. Gaede P, Vedel P, Parving H, Pedersen O. Intensified multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: The STENO type 2 randomised study. Lancet. 1999; 353:617-22.

Johannes Rübenthaler, Maximilian Reiser, Dirk-André Clevert.Diagnostic vascular ultrasonography with the help of color Doppler and contrast-enhanced ultrasonography.. 2016; 35: 289–301.

Yang Li, Jing-Jing Yang, Su-Hui Zhu, Biao Xu, Lian Wang. Long-term efficacy and safety of carotid artery stenting versus endarterectomy: A meta-analysis of randomized controlled trials.. 2017; 12(7).

Downloads

Published

2021-03-02

How to Cite

Shahid, S. ., Khattak, A. L. ., Bukhari, K. H. S. ., Uddin, R. ., & Khan, R. I. . (2021). Asymptomatic Carotid Artery Stenosis among Patients with Type II Diabetes Mellitus. Journal of Bahria University Medical and Dental College, 11(1), 27–30. https://doi.org/10.51985/AITH5490

Issue

Section

Original Articles

Most read articles by the same author(s)