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Prevalence of diabetes and/or ischaemic heart disease in classes of increasing carotid artery atherosclerosis: an ultrasonographic study
Author(s) -
Inchiostro S.,
Dalfollo M.,
Marzano A.,
Citroni N.,
Peccatori S.,
Fait D.,
De Venuto G.
Publication year - 2003
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2003.01016.x
Subject(s) - medicine , diabetes mellitus , cardiology , disease , logistic regression , endocrinology
Aims To evaluate the prevalence of non‐diabetic subjects and diabetic patients, with or without ischaemic heart disease (IHD), in different classes of increasing carotid atherosclerotic damage. Methods Using high‐resolution B‐mode ultrasound, we studied 598 subjects without known cardiovascular disease (CVD) or diabetes, 74 diabetic patients without CVD, 74 non‐diabetic subjects with IHD and 36 patients with both diabetes and IHD. Carotid atherosclerosis was classified as: normal; thickened intima‐media; non‐stenotic plaque; stenotic plaque. Results Compared with subjects without diabetes or CVD, the frequency of patients with diabetes without known CVD increased significantly from ‘normal’ to ‘stenotic plaque’ (4.1%, 6.4%, 13%, 14.8% for normal, thickened intima‐media, non‐stenotic plaque and stenotic plaque, respectively; P = 0.0057). The same figures were 6%, 7.6%, 10.2%, 23.3% ( P = 0.0007) for non‐diabetic subjects with IHD, and 0%, 2%, 5.6%, 15.9% ( P < 0.0001) for diabetic patients with IHD. No difference was found comparing subjects with diabetes without CVD with non‐diabetic patients with IHD ( P = 0.56). Using polychotomous logistic regression analysis, diabetic patients without CVD and non‐diabetic subjects with IHD showed a similar association with the increasing degree of carotid atherosclerosis ( P = 0.59), but significantly stronger compared with subjects without diabetes or CVD ( P < 0.03 for both). Conclusions Diabetic patients without known CVD show an advanced degree of carotid atherosclerotic damage similar to non‐diabetic subjects with IHD and significantly higher compared with non‐diabetic subjects without CVD. Our data support the need for an aggressive early prevention of CVD in diabetic subjects.