Key result
Composite carotid intima-media thickness significantly increased from healthy controls (0.56 mm) to prediabetics (0.69 mm) to diabetics (1.14 mm) (p<0.001), indicating early atherosclerotic changes.
Why the study?
Diabetic dyslipidaemia starts before the onset of diabetes, indicating the role of prediabetes as an atherosclerotic marker, but its biochemical changes and correlation with CIMT need evaluation.
How do lipid profiles and their correlation with carotid intima media thickness (CIMT) differ among type 2 diabetics, prediabetics, and healthy subjects?
Cross-Sectional (n=136)
Single-blind
No
How do lipid profiles and their correlation with carotid intima media thickness (CIMT) differ among type 2 diabetics, prediabetics, and healthy subjects?
Absolute Event Rate: 0.69% vs 0.56%
p-value: p=<0.001
Biochemical changes of atherosclerosis start in the prediabetes state, but lipid parameters do not significantly correlate with CIMT in prediabetics, suggesting CIMT is not yet highly raised at this stage.
Supports early atherosclerosis in prediabetes; leaves open lipid-CIMT links and requires prospective confirmation.
BACKGROUNDDiabetic dyslipidaemias cause coronary heart disease, cerebrovascular disease and other complications of atherosclerosis thus leading to high mortality and morbidity in type 2 diabetics.But diabetic dyslipidaemia starts even before the onset of diabetes thus indicating the role of prediabetes as an atherosclerotic marker. AIMS, SETTINGS AND DESIGNIn this study, we have tried to evaluate the dyslipidaemia associated with the type 2 diabetes mellitus and prediabetes and also the correlation between carotid artery intima media thickness (CIMT) with lipid profile in prediabetics and diabetics in a hospital based case control study consisting of 57 (42%) diabetics, 45 (33%) prediabetics and 34 (25%) healthy subjects within a span of one year. METHODSFasting glucose, postprandial glucose, total serum cholesterol (TC), high density cholesterol (HDL-c) and triglyceride (TG) were measured by standard pre-validated photometric tests as applicable.HbA1c or glycated haemoglobin was measured by HPLC (High Performance Liquid Chromatography).CIMT was measured by B mode ultrasonography. STATISTICAL ANALYSISThe data obtained were analysed using the statistical software, SPSS version 16.An alpha level of 5% has been taken, i.e. if any p value is less than 0.05 it has been considered as significant. RESULTS AND CONCLUSIONIn our study, the plasma total cholesterol, triglyceride, low density cholesterol (LDL-c) and very low density cholesterol (VLDLc) increased while plasma HDL-c decreased from Healthy to Prediabetes to Diabetes.CIMT also increased from Healthy to Prediabetes to Diabetes.Total cholesterol, triglyceride and LDL-c correlated positively, strongly and significantly with CIMT while HDL-c correlated negatively, strongly and significantly with CIMT in Healthy and Diabetics, but not in Prediabetics.Thus emphasising that though biochemical changes of atherosclerosis starts much before the onset of diabetes, in the prediabetes state only; but the insignificant correlation of lipid parameters with the Composite CIMT in the prediabetes population indicates that CIMT is not yet highly raised in the prediabetes state.
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Hazra et al. (2016) conducted a cross-sectional in Prediabetes and Type 2 Diabetes Mellitus (n=136). Prediabetes and Diabetes vs. Healthy controls was evaluated on Composite Carotid Intima Media Thickness (CIMT) (p=<0.001). Composite carotid intima-media thickness significantly increased from healthy controls (0.56 mm) to prediabetics (0.69 mm) to diabetics (1.14 mm) (p<0.001), indicating early atherosclerotic changes.
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