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A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes

BACKGROUND: Subjects with type 2 diabetes are at an increased risk of vascular complications. The use of carotid ultrasound remains an attractive, non-invasive method to monitor atherosclerotic disease progression and/or response to treatment in patients with type 2 diabetes, with intima-media thick...

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Autores principales: Pollex, Rebecca L, Spence, J David, House, Andrew A, Fenster, Aaron, Hanley, Anthony JG, Zinman, Bernard, Harris, Stewart B, Hegele, Robert A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1184090/
https://www.ncbi.nlm.nih.gov/pubmed/15958169
http://dx.doi.org/10.1186/1476-7120-3-15
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author Pollex, Rebecca L
Spence, J David
House, Andrew A
Fenster, Aaron
Hanley, Anthony JG
Zinman, Bernard
Harris, Stewart B
Hegele, Robert A
author_facet Pollex, Rebecca L
Spence, J David
House, Andrew A
Fenster, Aaron
Hanley, Anthony JG
Zinman, Bernard
Harris, Stewart B
Hegele, Robert A
author_sort Pollex, Rebecca L
collection PubMed
description BACKGROUND: Subjects with type 2 diabetes are at an increased risk of vascular complications. The use of carotid ultrasound remains an attractive, non-invasive method to monitor atherosclerotic disease progression and/or response to treatment in patients with type 2 diabetes, with intima-media thickness routinely used as the gold standard to detect pathology. However, alternative measurements, such as plaque area or volume, may represent a potentially more powerful approach. Thus, the objective of this study was to compare the traditional intima-media thickness measurement against the novel total plaque volume measurement in analyzing carotid atherosclerosis development in individuals with type 2 diabetes. METHODS: The case-control study included 49 Oji-Cree adults with diabetes or impaired glucose tolerance, aged 21–69, and 49 sex- and age-matched normoglycemic subjects. At baseline, metabolic variables were measured, including body mass index, waist circumference, total cholesterol:high density lipoprotein ratio, plasma triglycerides, plasma glucose, and serum insulin. Carotid ultrasound measurements, 7 years later, assessed carotid arterial intima-media thickness and total plaque volume. RESULTS: At baseline, the two groups were well matched for smoking habits, hypertension, body mass index, and waist circumference. Differences were noted in baseline measurements of total cholesterol:high density lipoprotein (P = 0.0006), plasma triglycerides (P < 0.0001) and fasting glucose (P < 0.0001). After seven years, carotid ultrasound scans revealed that total plaque volume measurements (P = 0.037), but not intima-media thickness measurements, were higher in subjects with diabetes/impaired glucose tolerance compared to the normoglycemic controls. Correlation between intima-media thickness and total plaque volume was moderate. Based on our study findings, to achieve power levels >0.70 when comparing intima-media thickness measurements for diabetics versus non-diabetics, thousands of study subjects are required. For comparing total plaque volume measurements, only hundreds of study subjects are required. CONCLUSION: The development of atherosclerotic plaque is greater in subjects with diabetes/impaired glucose tolerance. Total plaque volume appears to capture the atherosclerotic disease burden more effectively in subjects with type 2 diabetes, and would be an appropriate outcome measure for studies aimed at changing the diabetic milieu.
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spelling pubmed-11840902005-08-11 A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes Pollex, Rebecca L Spence, J David House, Andrew A Fenster, Aaron Hanley, Anthony JG Zinman, Bernard Harris, Stewart B Hegele, Robert A Cardiovasc Ultrasound Research BACKGROUND: Subjects with type 2 diabetes are at an increased risk of vascular complications. The use of carotid ultrasound remains an attractive, non-invasive method to monitor atherosclerotic disease progression and/or response to treatment in patients with type 2 diabetes, with intima-media thickness routinely used as the gold standard to detect pathology. However, alternative measurements, such as plaque area or volume, may represent a potentially more powerful approach. Thus, the objective of this study was to compare the traditional intima-media thickness measurement against the novel total plaque volume measurement in analyzing carotid atherosclerosis development in individuals with type 2 diabetes. METHODS: The case-control study included 49 Oji-Cree adults with diabetes or impaired glucose tolerance, aged 21–69, and 49 sex- and age-matched normoglycemic subjects. At baseline, metabolic variables were measured, including body mass index, waist circumference, total cholesterol:high density lipoprotein ratio, plasma triglycerides, plasma glucose, and serum insulin. Carotid ultrasound measurements, 7 years later, assessed carotid arterial intima-media thickness and total plaque volume. RESULTS: At baseline, the two groups were well matched for smoking habits, hypertension, body mass index, and waist circumference. Differences were noted in baseline measurements of total cholesterol:high density lipoprotein (P = 0.0006), plasma triglycerides (P < 0.0001) and fasting glucose (P < 0.0001). After seven years, carotid ultrasound scans revealed that total plaque volume measurements (P = 0.037), but not intima-media thickness measurements, were higher in subjects with diabetes/impaired glucose tolerance compared to the normoglycemic controls. Correlation between intima-media thickness and total plaque volume was moderate. Based on our study findings, to achieve power levels >0.70 when comparing intima-media thickness measurements for diabetics versus non-diabetics, thousands of study subjects are required. For comparing total plaque volume measurements, only hundreds of study subjects are required. CONCLUSION: The development of atherosclerotic plaque is greater in subjects with diabetes/impaired glucose tolerance. Total plaque volume appears to capture the atherosclerotic disease burden more effectively in subjects with type 2 diabetes, and would be an appropriate outcome measure for studies aimed at changing the diabetic milieu. BioMed Central 2005-06-15 /pmc/articles/PMC1184090/ /pubmed/15958169 http://dx.doi.org/10.1186/1476-7120-3-15 Text en Copyright © 2005 Pollex et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Pollex, Rebecca L
Spence, J David
House, Andrew A
Fenster, Aaron
Hanley, Anthony JG
Zinman, Bernard
Harris, Stewart B
Hegele, Robert A
A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes
title A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes
title_full A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes
title_fullStr A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes
title_full_unstemmed A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes
title_short A comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes
title_sort comparison of ultrasound measurements to assess carotid atherosclerosis development in subjects with and without type 2 diabetes
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1184090/
https://www.ncbi.nlm.nih.gov/pubmed/15958169
http://dx.doi.org/10.1186/1476-7120-3-15
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