Arterial thickness measurements on high-resolution ultrasonography in diabetics with and without macrovascular complications and their relationship with homocysteine level.

Abstract

Background: Pathological changes in the arterial vasculature play a pivotal role in the development of macrovascular and microvascular complications of diabetes mellitus (DM). Compared with traditional measurements of carotid artery intima-media thickness, separate measurements of the thickness of the intima and the media using high-resolution ultrasonography could reveal vascular anatomical changes more precisely. Homocysteine (HCY) is closely related to vascular complications in DM patients. This study aimed to explore the thickness of the intima and media separately in the carotid, radial, and dorsalis pedis arteries in DM patients, to examine their diagnostic value for DM with complications and their relationship with HCY.

Methods: This was a cross-sectional study. A total of 123 DM patients and 102 healthy controls were enrolled. Arterial ultrasonography was performed using a 24-MHz probe to measure the thickness of the intima and media in the carotid, radial, and pedal arteries. Serum levels of fasting glucose, low-density lipoprotein cholesterol, HCY, and clinical information were also collected. Multivariate linear regression was performed to investigate the association between ultrasonographic parameters and risk factors, and binary logistic regression was used to explore the diagnostic value of combination model for DM with complications.

Results: Carotid, radial, and pedal artery intima thickness were substantially thicker in DM patients than controls. Compared with DM patients without macrovascular complications, those with macrovascular complications exhibited a thicker media in all three arteries, a thicker carotid intima, and a thicker carotid artery intima-media thickness. The relative difference was greatest for carotid artery media thickness (28.4%). HCY positively correlated with all MTs and CIT in DM patients. CIT was associated with traditional risk factors including age, systolic blood pressure and HCY. Combination model of age, SBP and CIT provides a satisfactory diagnostic value for DM patients with macrovascular complications (area under the curve, 0.827).

Conclusions: Measurement of arterial intima and media thickness using high-resolution ultrasonography might be a promising tool to reveal arterial pathological changes in DM patients.