Ultrasound Findings of Carotid Arteries in Patients with Type-2 Diabetes Mellitus

Shino Bahaadin  Taha; Aska Faruq  Jamal

doi:10.56056/amj.2024.266

Authors

Shino Bahaadin Taha M.B.Ch.B, trainee at Kurdistan Board/Diagnostic Radiology-Rizgari Teaching Hospital in Hawler city-Kurdistan region/Iraq
[email protected] MBChB, C.A.B.R., Consultant Radiologist-Rizgari Teaching Hospital-Hawler city-Kurdistan region/Iraq.

DOI:

https://doi.org/10.56056/amj.2024.266

Keywords:

Doppler ultrasonography, Kurdistan region, Stenosis, Type 2 diabetes mellitus

Abstract

Background and objectives: Type 2 diabetes mellitus is common public health problem nationally and globally. Early detection of the vascular changes with inexpensive and non-invasive techniques is important in the process of management of type 2 diabetes mellitus. The aim of this study was to determine the frequency and grading of carotid artery atherosclerosis using color doppler ultrasound in type 2 diabetes mellitus.

Methods: A cross-sectional study was implemented in Radiology Department of Rizgari Teaching Hospital in Hawler city-Kurdistan Region during the period of six months from 1^st of March to 1^st of September, 2022. Sixty cases of type 2 diabetic patients included in the study and referred from Layla Qasim diabetic center and Rizgari Hospital Outpatient. Left and right carotid arteries (common, internal and bulb) were examined by ultrasound and intima-media thickness were measured, plaque, stenosis and occlusion were looked for. Patients more than 18 years old with type 2 diabetes mellitus included in the study and patients with recent stroke, type 1 diabetes and history of neck surgery were excluded.

Results: The mean intima-media thickness of type 2 diabetic patients were higher in both right and left carotid artery bulb (65% and 73.3%) than common (6.7% and 21.7%) and internal carotid arteries (16.7% and 21.7%). The stenosis was observed in 21.7% in each right and left carotid bulb with less proportion of stenosis in common (0% and 1.7%) and internal carotid arteries (8.3% and 3.3%). There was a significant association between smoker and elderly age type 2 diabetic patients and carotid artery stenosis (p=0.03 and p=0.001 respectively).

Conclusions: Diabetes mellitus is a common cause of atherosclerotic changes in carotid arteries mainly in the bulb and more on left side. Smoking and elderly age are the common associated factors.

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References

Wang CCL, Hess CN, Hiatt WR, Goldfine AB. Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes–mechanisms, management, and clinical considerations. Circulation. 2016;133(24):2459.

Kissela BM, Khoury J, Kleindorfer D, et al. Epidemiology of ischemic stroke in patients with diabetes: the greater Cincinnati/Northern Kentucky Stroke Study. Diabetes Care. 2005;28(2):355-9.

Carpenter M, Sinclair H, Kunadian V. Carotid intima media thickness and its utility as a predictor of cardiovascular disease: a review of evidence. Cardiol Rev

.2016;24(2):70-5.

Buse J. Type 2 Diabetes mellitus In: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS, editors. Williams textbook of endocrinology. Philadelphia: WB Saunders Co; 2003.

Chaudhuri J, Bains Y, Guha S, et al. The role of advanced glycation end products in aging and metabolic diseases: bridging association and causality. Cell Metab

.. 2018;28(3):337-52.

Shah MS, Brownlee M. Molecular and cellular mechanisms of cardiovascular disorders in diabetes Circ Res. 2016;118(11):1808-29.

Vrsalovic M, Vucur K, Vrsalovic Presecki A, Fabijanic D, Milosevic M. Impact of diabetes on mortality in peripheral artery disease: a meta?analysis. Clin Cardiol.

;40(5):287-91.

Aronson D, Edelman ER. Coronary artery disease and diabetes mellitus. Cardiol Clin. 2014;32(3):439-55.

Hill MD. Stroke and diabetes mellitus. Handb Clin Neurol. 2014;126: 167-74. doi: 10.1016/B978-0-444-53480-4.00012-6.

Naqvi TZ, Lee M-S. Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging.2014; 7(10):1025-38..

Katakami N, Matsuoka Ta, Shimomura I. Clinical utility of carotid ultrasonography: application for the management of patients with diabetes. J Diabetes Investig. 2019;10(4):883-98.

Stein JH, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr. 2008;21(2):93-111.

Wada S, Koga M, Toyoda K, et al. Japan Statin treatment against recurrent stroke (J-STARS) echo study collaborators. Factors associated with intima-media complex thickness of the common carotid artery in Japanese noncardioembolic Stroke patients with hyperlipidemia: the J-STARS echo study. J Atheroscler Thromb. 2018; 25:359-73.

Polak JF, Pencina MJ, Pencina KM, O'Donnell CJ, Wolf PA, D'Agostino Sr RB. Carotid-wall intima–media thickness and cardiovascular events. N Engl J Med

. 2011;365(3):213-21.

Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007;115(4):459-67.

Polak JF, O'Leary DH. Carotid intima-media thickness as surrogate for and predictor of CVD. Glob Heart. 2016;11(3):295-312. e3.

AL-Siaidy WF, AL-Sabbagh AA, AL-Karawi IN, Mohammed DA. Evaluation of Ankle-Brachial pressure index and carotid intima media thickness by doppler ultrasound in type two Diabetics. J Fac Med Baghdad. 2013;55(1):77-82.

Ali FS, Bader N, Zuberi BF, Banu S. Frequency of silent carotid artery stenosis in diabetics and its associated factors: An analysis in tertiary care hospital. Pak J Med Sci. 2020;36(6):1270.

Klimontov VV, Koroleva EA, Khapaev RS, Korbut AI, Lykov AP. Carotid artery disease in subjects with type 2 Diabetes: Risk factors and biomarkers. J Clin Med. 2021;11(1):72.

Hussein II. Does doppler ultrasonography of carotid arteries explore preclinical atherosclerosis. Iraqi J Community Med. 2011;24(3).

Adekoya AO, Olatunji AA, Akinola AR, Odunsan O, Adekoya AO, Olawale O. Carotid doppler ultrasonography in patients with Co-existing type 2 Diabetes mellitus and hypertension in Nigeria. Annals of Health Research. 2022;8(1):49-62.

Safri LS, Lip HTC, Saripan MI, et al. Older age and duration of exposure to type 2 diabetes in selective screening of asymptomatic carotid artery stenosis for primary stroke prevention—A single institution experience. Prim Care Diabetes. 2020;14(4):364-9.

Sultana N, Islam M. Doppler Evaluation of Carotid Vessels in Type 2 Diabetes.

Mymensingh Med J. 2020;29(3):572-8.