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01-06-2012 | Original Article

Carotid artery intima-media thickness and elasticity in relation to glucose tolerance

Authors: Kalle Sipilä, Mika Kähönen, Veikko Salomaa, Markku Päivänsalo, Hannu Karanko, Marjut Varpula, Antti Jula, Risto Kaaja, Y. Antero Kesäniemi, Antti Reunanen, Leena Moilanen

Published in: Acta Diabetologica | Issue 3/2012

Abstract

The association between diabetes and subclinical atherosclerosis is well established. The effect of non-diabetic glucose intolerance on early atherosclerosis is not as straightforward, and the data regarding sex-related differences in this matter are limited. Therefore, our aim was to investigate these associations in men and women separately. We studied 1,304 Finnish men and women over 45 years of age who participated in the Finnish Health 2000 Survey. Ultrasonically determined carotid artery intima-media thickness and elasticity were used as markers of early atherosclerosis. Glucose tolerance was categorized according to the American Diabetes Association criteria for diabetes mellitus. Age-adjusted means for carotid artery intima-media thickness and elasticity indices were significantly (P < 0.05) associated with glucose tolerance status in both sexes. There was a trend of increasing early atherosclerosis with the worsening of glucose tolerance in men and women. These associations were weakened in both sexes after further adjustments for other cardiovascular risk factors. In women, but not in men, significant (P < 0.05) associations between glucose tolerance status and carotid artery elasticity were seen even after these further adjustments. Diabetes and non-diabetic glucose intolerance are associated with increased early carotid atherosclerosis compared with normal glucose tolerance in both sexes. Our results suggest that women with glucose intolerance may be in greater risk than men.

Kannel WB, McGee DL (1979) Diabetes and cardiovascular disease. The Framingham study. JAMA 241:2035–2038PubMedCrossRef

Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R, Kitzmiller J, Knowler WC, Lebovitz H, Lernmark A, Nathan D, Palmer J, Rizza R, Saudek C, Shaw J, Steffes M, Stern M, Tuomilehto J, Zimmet P, Expert Committee on the Diagnosis, Classification of Diabetes Mellitus (2003) Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 26:3160–3167PubMedCrossRef

Stancakova A, Javorsky M, Kuulasmaa T, Haffner SM, Kuusisto J, Laakso M (2009) Changes in insulin sensitivity and insulin release in relation to glycemia and glucose tolerance in 6, 414 Finnish men. Diabetes 58:1212–1221PubMedCrossRef

Barr EL, Zimmet PZ, Welborn TA, Jolley D, Magliano DJ, Dunstan DW, Cameron AJ, Dwyer T, Taylor HR, Tonkin AM, Wong TY, McNeil J, Shaw JE (2007) Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation 116:151–157PubMedCrossRef

Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE (1997) Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 96:1432–1437PubMed

O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr (1999) Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 340:14–22PubMedCrossRef

Staub D, Meyerhans A, Bundi B, Schmid HP, Frauchiger B (2006) Prediction of cardiovascular morbidity and mortality: comparison of the internal carotid artery resistive index with the common carotid artery intima-media thickness. Stroke 37:800–805PubMedCrossRef

Stork S, van den Beld AW, von Schacky C, Angermann CE, Lamberts SW, Grobbee DE, Bots ML (2004) Carotid artery plaque burden, stiffness, and mortality risk in elderly men: a prospective, population-based cohort study. Circulation 110:344–348PubMedCrossRef

Niskanen L, Rauramaa R, Miettinen H, Haffner SM, Mercuri M, Uusitupa M (1996) Carotid artery intima-media thickness in elderly patients with NIDDM and in nondiabetic subjects. Stroke 27:1986–1992PubMedCrossRef

10.

Folsom AR, Eckfeldt JH, Weitzman S, Ma J, Chambless LE, Barnes RW, Cram KB, Hutchinson RG (1994) Relation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke 25:66–73PubMedCrossRef

11.

Salomaa V, Riley W, Kark JD, Nardo C, Folsom AR (1995) Non-insulin-dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes. The ARIC Study. Atherosclerosis Risk in Communities Study. Circulation 91:1432–1443PubMed

12.

Henry RM, Kostense PJ, Spijkerman AM, Dekker JM, Nijpels G, Heine RJ, Kamp O, Westerhof N, Bouter LM, Stehouwer CD, Study Hoorn (2003) Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study. Circulation 107:2089–2095PubMedCrossRef

13.

Brohall G, Oden A, Fagerberg B (2006) Carotid artery intima-media thickness in patients with Type 2 diabetes mellitus and impaired glucose tolerance: a systematic review. Diabet Med 23:609–616PubMedCrossRef

14.

van Popele NM, Elizabeth Hak A, Mattace-Raso FU, Bots ML, van der Kuip DA, Reneman RS, Hoeks AP, Hofman A, Grobbee DE, Witteman JC (2006) Impaired fasting glucose is associated with increased arterial stiffness in elderly people without diabetes mellitus: the Rotterdam Study. J Am Geriatr Soc 54:397–404PubMedCrossRef

15.

Tropeano AI, Boutouyrie P, Katsahian S, Laloux B, Laurent S (2004) Glucose level is a major determinant of carotid intima-media thickness in patients with hypertension and hyperglycemia. J Hypertens 22:2153–2160PubMedCrossRef

16.

Hanefeld M, Temelkova-Kurktschiev T, Schaper F, Henkel E, Siegert G, Koehler C (1999) Impaired fasting glucose is not a risk factor for atherosclerosis. Diabet Med 16:212–218PubMedCrossRef

17.

Beckman JA, Creager MA, Libby P (2002) Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA 287:2570–2581PubMedCrossRef

18.

Kawamoto R, Tomita H, Ohtsuka N, Inoue A, Kamitani A (2007) Metabolic syndrome, diabetes and subclinical atherosclerosis as assessed by carotid intima-media thickness. J Atheroscler Thromb 14:78–85PubMedCrossRef

19.

Bonora E, Kiechl S, Oberhollenzer F, Egger G, Bonadonna RC, Muggeo M, Willeit J (2000) Impaired glucose tolerance, Type II diabetes mellitus and carotid atherosclerosis: prospective results from the Bruneck Study. Diabetologia 43:156–164PubMedCrossRef

20.

Niiranen T, Jula A, Kantola I, Moilanen L, Kahonen M, Kesaniemi YA, Nieminen MS, Reunanen A (2007) Home-measured blood pressure is more strongly associated with atherosclerosis than clinic blood pressure: the Finn-HOME Study. J Hypertens 25:1225–1231PubMedCrossRef

21.

Juonala M, Järvisalo MJ, Mäki-Torkko N, Kähönen M, Viikari JS, Raitakari OT (2005) Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular Risk in Young Finns Study. Circulation 112:1486–1493PubMedCrossRef

22.

Hirai T, Sasayama S, Kawasaki T, Yagi S (1989) Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. Circulation 80:78–86PubMedCrossRef

23.

Wagenknecht LE, D’Agostino RB Jr, Haffner SM, Savage PJ, Rewers M (1998) Impaired glucose tolerance, type 2 diabetes, and carotid wall thickness: the Insulin Resistance Atherosclerosis Study. Diabetes Care 21:1812–1818PubMedCrossRef

24.

Mohan V, Gokulakrishnan K, Sandeep S, Srivastava BK, Ravikumar R, Deepa R (2006) Intimal media thickness, glucose intolerance and metabolic syndrome in Asian Indians—the Chennai Urban Rural Epidemiology Study (CURES -22). Diabet Med 23:845–850PubMedCrossRef

25.

Bonora E, Tessari R, Micciolo R, Zenere M, Targher G, Padovani R, Falezza G, Muggeo M (1997) Intimal-medial thickness of the carotid artery in nondiabetic and NIDDM patients. Relationship with insulin resistance. Diabetes Care 20:627–631PubMedCrossRef

26.

Menghini R, Casagrande V, Cardellini M, Martelli E, Terrinoni A, Amati F, Vasa-Nicotera M, Ippoliti A, Novelli G, Melino G, Lauro R, Federici M (2009) MicroRNA 217 modulates endothelial cell senescence via silent information regulator 1. Circulation 120:1524–1532PubMedCrossRef

27.

Cardellini M, Menghini R, Martelli E, Casagrande V, Marino A, Rizza S, Porzio O, Mauriello A, Solini A, Ippoliti A, Lauro R, Folli F, Federici M (2009) TIMP3 is reduced in atherosclerotic plaques from subjects with type 2 diabetes and increased by SirT1. Diabetes 58:2396–2401PubMedCrossRef

28.

Rizza S, Tesauro M, Cardellini M, Menghini R, Bellia A, Marini MA, Lauro D, Sbraccia P, Sesti G, Lauro R, Federici M (2006) Insulin resistance and increased intimal medial thickness in glucose tolerant offspring of type 2 diabetic subjects carrying the D298D genotype of endothelial nitric oxide synthase. Arterioscler Thromb Vasc Biol 26:431–432PubMedCrossRef

29.

Wu W, Wang M, Sun Z, Wang X, Miao J, Zheng Z (2010) The predictive value of TNF-alpha and IL-6 and the incidence of macrovascular complications in patients with type 2 diabetes. Acta Diabetol [Epub ahead of print]

30.

Park JS, Cho MH, Nam JS, Ahn CW, Cha BS, Lee EJ, Lim SK, Kim KR, Lee HC (2010) Visceral adiposity and leptin are independently associated with C-reactive protein in Korean type 2 diabetic patients. Acta Diabetol 47:113–118PubMedCrossRef

31.

Temelkova-Kurktschiev TS, Koehler C, Leonhardt W, Schaper F, Henkel E, Siegert G, Hanefeld M (1999) Increased intimal-medial thickness in newly detected type 2 diabetes: risk factors. Diabetes Care 22:333–338PubMedCrossRef

32.

Wei M, Gonzalez C, Haffner SM, O’Leary DH, Stern MP (1996) Ultrasonographically assessed maximum carotid artery wall thickness in Mexico City residents and Mexican Americans living in San Antonio, Texas. Association with diabetes and cardiovascular risk factors. Arterioscler Thromb Vasc Biol 16:1388–1392PubMedCrossRef

33.

Howard BV, Cowan LD, Go O, Welty TK, Robbins DC, Lee ET (1998) Adverse effects of diabetes on multiple cardiovascular disease risk factors in women. The Strong Heart Study. Diabetes Care 21:1258–1265PubMedCrossRef

34.

Jansson PA, Pellme F, Hammarstedt A, Sandqvist M, Brekke H, Caidahl K, Forsberg M, Volkmann R, Carvalho E, Funahashi T, Matsuzawa Y, Wiklund O, Yang X, Taskinen MR, Smith U (2003) A novel cellular marker of insulin resistance and early atherosclerosis in humans is related to impaired fat cell differentiation and low adiponectin. FASEB J 17:1434–1440PubMedCrossRef

Title: Carotid artery intima-media thickness and elasticity in relation to glucose tolerance
Authors: Kalle Sipilä
Mika Kähönen
Veikko Salomaa
Markku Päivänsalo
Hannu Karanko
Marjut Varpula
Antti Jula
Risto Kaaja
Y. Antero Kesäniemi
Antti Reunanen
Leena Moilanen
Publication date: 01-06-2012
Publisher: Springer Milan
Published in: Acta Diabetologica / Issue 3/2012
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-011-0291-z

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