Postprandial plasma glucose is an independent risk factor for increased carotid intima-media thickness in non-diabetic individuals

Introduction: Diabetes mellitus is a well-known risk factor for cardiovascular disease, because of the accelerated process of atherosclerosis. Obesity is an established risk factor and has gained immense importance in recent studies as an important risk factor for clinical cardiovascular disease, yet the fundamental component stays unclear. Calf circumference is another form for lean mass and peripheral subcutaneous fat and is inversely associated with occurrence of carotid plaques (CP). Multiplicative and opposite effects of both Calf Circumference (CC) and Waist Circumference (WC) in event of CP suggest that the two measures should be taken into account commonly while assessing vascular risk profile. Aim & Objective: To ascertain if waist to calf circumference ratio (WCR) is a marker of Carotid atherosclerosis in patients with type 2 diabetes mellitus. To asses s the correlation between waist to calf circumference ratio and carotid intima media thickness (CIMT ) in patients with Type 2 diabetes. Materials and methods: A cross sectional study at Hospital affiliated to Kasturba Medical college Mangalore from Sept 2016 to Sept 2018 . Method of study: Patients with type 2 DM as per ADA criteria, age >18years are recruited for the study. Results and discussion: In our study with 150 population 25 patients had carotid atherosclerosis and 20 patients had CIMT>1.1. The waist circumference in patients with CA is in the range of 93.07 and 99.85 & the CC in patients with CA is in the range of 29.49 to 31.25. The WCR in patients with CA is in the range of 3.12 to 3.26. The difference was statistically significant with a p value of <0.05. In our study it was found that WC and WCR correlated well with carotid atherosclerosis, and surprisingly calf circumference also correlated with carotid atherosclerosis but not as significant as both WC and WCR. Conclusion: To conclude, in our population based study of 150 subjects we found that carotid atherosclerosis is significantly more in people with increased waist calf circumference ratio. WCR may be a new, useful and practical anthropometric index that facilitates the early identification of diabetic subjects with high risk for cardiovascular disease. Validation of this finding in individual populations is required. Future studies should test the association of calf circumference with carotid intima media thickness and carotid plaques using better measures than ultrasound such as magnetic resonance imaging. Further research focusing on underlying mechanisms in the role of lean mass and peripheral fat mass is required.

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Associations of Plasma Glucose Levels and Traits of Metabolic Syndrome with Carotid Intima Media Thickness in Nondiabetic Elderly Subjects: Are They Mediated by Insulin Resistance?

Metabolic Syndrome and Related Disorders ◽

10.1089/met.2012.0087 ◽

2013 ◽

Vol 11 (1) ◽

pp. 41-45 ◽

Cited By ~ 7

Author(s):

Giovanni Viscogliosi ◽

Paola Andreozzi ◽

Vincenzo Marigliano

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Plasma Glucose ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Elderly Subjects ◽

Glucose Levels ◽

Media Thickness

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Carotid intima–media thickness relative to cognitive impairment in dialysis patients, and their relationship with brain volume and cerebral small vessel disease

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622320953352 ◽

2020 ◽

Vol 11 ◽

pp. 204062232095335

Author(s):

Ke Zheng ◽

Yujun Qian ◽

Tiaye Lin ◽

Fei Han ◽

Hui You ◽

...

Keyword(s):

Risk Factor ◽

Cognitive Impairment ◽

Cognitive Function ◽

Brain Atrophy ◽

Brain Volume ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Dialysis Patients ◽

Matter Volume ◽

Media Thickness

Background: Carotid intima–media thickness (cIMT) is considered a risk factor for and predictor of cerebrovascular disease. In this study, we explored the contribution of cIMT to cognitive impairment (CI) in dialysis patients and the role of cerebral small vascular disease (CSVD) and brain atrophy in this process. Methods: Cognitive function was assessed using a comprehensive cognitive test battery. CSVD and brain volume were assessed by magnetic resonance imaging, and cIMT was measured by ultrasonography. Multivariable analysis and mediation were used to explore the relevant relationships among cIMT, CI, CSVD and brain volume. Results: Seventy-three dialysis patients were enrolled. Approximately 54.8% were diagnosed with increased cIMT. The increased cIMT group was older and had lower serum albumin and creatinine levels than the normal cIMT group. There was no difference in the CSVD prevalence between the different cIMT groups. Patients in the normal, unilaterally and bilaterally increased cIMT subgroups demonstrated a gradual decrease in brain-matter volume and degenerate cognitive function. cIMT was related to cognitive function and gray-/white-matter volume. Increased cIMT was associated with a significantly increased risk of a reduced Mini Mental State Examination/Montreal Cognitive Assessment score and Trail A/B time delay. Mediation analysis showed that CI was mediated by brain-matter volume but not by CSVD. Conclusion: Increased cIMT was an independent risk factor for impairment of global cognitive function, memory, and executive function. The impact of cIMT on cognition was not induced by CSVD but by brain atrophy. cIMT may be a useful tool for screening patients at high risk of CI in the dialysis population.

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