Correlations between Body Compositions with Subclinical Atherosclerosis as Assessed by Carotid Artery Intima Media Thickness in Patients with Type 2 Diabetes Mellitus: A Single Centre Study in Southern Sri Lanka

Background: Type 2 diabetes mellitus (T2DM) is a risk factor for atherosclerosis. Subclinical atherosclerosis is identified by measuring carotid artery intima media thickness (CIMT) with ultrasound. This study describes selected factors associated with CAIMT and cardiovascular disease (CVD) risk in patients with T2DM.

Materials and methods: Data of 212 patients registered at a diabetes center in Southern Sri Lanka was analyzed. Details on demographic characteristics, anthropometry, fat mass, glycated haemoglobin (HbA1c) level and CIMT of both common carotid arteries were collected. Association of these parameters with CIMT was elicited using appropriate statistical tests.

Results: There were 98 males and 114 females with the mean age of 58±10 years. Majority of them had overweight and obesity. Poor glycemic control (HbA1c>7%) was detected in 164 (73.3%) patients. There were 166 (78.3%) patients with increased CVD risk (≥ 75th percentile CIMT) based on age and gender specific values. Significant positive correlations were observed between mean CIMT and mean age (r=0.308, p=0.001), age of initial detection of T2DM (r=0.180, p=0.008), duration of T2DM (r=0.228, p=0.001), mean HbA1c (r=0.206, p=0.003) and visceral adiposity (r=0.239, p=0.001). Males had significantly higher mean CIMT (0.736±0.16 vs. 0.678±0.011, p=0.003) and visceral fat (12.3±5.0 vs. 9.9±3.9, p=0.001) than females.

Conclusions: This study underscores that a majority of T2DM patients demonstrated both obesity and suboptimal glycemic control, thus elevating their CVD risk. Factors including age, duration of T2DM, late age of diagnosis, elevated levels of visceral fat, and poor glycemic control were substantively correlated with increased CIMT.