Short-Duration Type 2 Diabetes Associated With Adverse Vascular Effects

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Obesity was associated with an increased carotid necrotic core volume and calcification in patients with and without type 2 diabetes.
Obesity was associated with an increased carotid necrotic core volume and calcification in patients with and without type 2 diabetes.

Type 2 diabetes (T2D) was associated with an increased carotid plaque burden and negative remodeling, even when early in the diagnosis, according to findings published in the Journal of the American Heart Association.

Obesity was also associated with an increased carotid necrotic core volume and calcification in patients with T2D and those without it.

In this study, the researchers evaluated the effect of short-duration T2D and obesity on carotid remodeling and plaque burden in a cohort of patients with T2D (duration <5 years) and 100 matched control patients. All participants underwent bilateral carotid artery magnetic resonance imaging in a 1.5-T magnetic resonance imaging scanner, and plaque burden was quantified by normalized wall index, maximum wall thickness, maximum wall area, and minimum lumen size. Magnetic resonance imaging data were available for 149 carotid arteries of the patients with T2D and 177 from the control patients.

Adjusted data showed that T2D was associated with an increased plaque burden that was demonstrated by a higher normalized wall index (ratio, 1.03; 95% CI, 1.002-1.06; P =.03), and negative remodeling indicated by a lower minimum lumen area (ratio, 0.81; 95% CI, 0.74-0.89; P <.001) and lower maximum wall area (ratio, 0.94; 95% CI, 0.88-0.999; P =.048) vs the control group. For both patients with T2D and control patients, a high body mass index (≥30.0 kg/m2) was associated with an 80% increase in total calcified plaque volume and a 44% increase in necrotic core volume vs lower body mass index (<25.0 kg/m2).

"Our results point to the atherogenic effect of the metabolic syndrome, herein [T2D] and obesity," concluded the investigators.

Reference

Esben Laugesen, Pernille Høyem, Samuel Thrysoe, et al. Negative carotid artery remodeling in early type 2 diabetes mellitus and increased carotid plaque vulnerability in obesity as assessed by magnetic resonance imaging. J Am Heart Assoc. 2018;7:e008677.

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