Association of postprandial hypertriglyceridemia with carotid intima-media thickness in patients with Type 2 diabetes mellitus

Background: Cardiovascular disease is the leading cause of morbidity and mortality in patients with Type 2 diabetes mellitus (T2DM). Evidence suggests a stronger association of postprandial hypertriglyceridemia with subclinical atherosclerosis than fasting triglyceride levels. Carotid intima-media thickness (CIMT) is a validated, non-invasive marker for early atherosclerotic changes. Aims and Objectives: The aim of the study was to assess the association of post-prandial high triglyceride levels and thickening of the carotid intima media in people with T2DM. Materials and Methods: This prospective observational study was conducted over 12 months between June 2024 and May 2025. Patients aged 35–75 years with a disease duration of at least 1 year were enrolled. Fasting and postprandial lipid profiles and glucose levels of the patients were evaluated. CIMT was measured using high-resolution B-mode ultrasonography. Statistical analysis included Pearson correlation and logistic regression to identify associations and predictors. Results: Mean postprandial triglyceride level was 212.5±45.6 mg/dL and mean CIMT was 1.11±0.20 mm. Patients with postprandial triglycerides (TG) ≥200 mg/dL had significantly higher CIMT values compared to those with lower levels (1.20±0.18 mm vs. 1.02±0.17 mm; P<0.001). Postprandial TG showed a strong positive correlation with CIMT (r=0.621, P<0.001), stronger than fasting TG. Postprandial triglyceride level ≥200 mg/dL was the strongest independent predictor of increased CIMT (odds ratio: 3.82, P<0.001). Conclusion: Postprandial hypertriglyceridemia is significantly associated with increased CIMT in patients with T2DM, suggesting its important role in early atherosclerosis and cardiovascular risk.