Endocrine Abstracts (2008) 16 P209

Relationship of insulin sensitivity with carotid intima media thickness in patients with type 2 diabetes mellitus

Angel Marinchev & Petya Kamenova


University Specialized Hospital for Active Treatment in Endocrinology ‘Acad. Iv. Penchev’, Sofia, Bulgaria.


Objective: The study was to establish the association between insulin sensitivity (IS) and carotid intima media thickness (CIMT) in type 2 diabetic patients (T2D pts).

Materials and methods: 40 (21 f,19 m) T2D pts aged 58.1±10.2 years, BMI 30.1±5.8 kg/m2 (mean±S.D.); 36 (19 f, 17 m) normal glucose tolerant (NGT) subjects of mean age 57±10.1 years, as a control group in terms of IS, and 38 (20 f, 18 m) NGT subjects of mean age 57.6±9.4 years, as a control group in terms of CIMT, participated in the study. IS was measured with a manual hyperinsulinaemic euglycaemic clamp technique and expressed as a glucose disposal rate (M; mg/kg per min). CIMT was assessed using B mode sonograph ‘Ultrasonix’, M’Ath Software in both right common carotid artery (CCAr) and left common carotid artery (CCAl). The study was approved by Local Ethical Committee.

Results: IMTCCAr 0.76±0.15 mm and IMTCCAl 0.82±0.21 mm of T2D pts were significantly higher than IMTCCAr 0.59±0.12 mm and IMTCCAl 0.58±0.10 mm of NGT subjects, both P<0.001. IS (M) of T2D pts significantly inversely correlated with IMTCCAr r=−0.51 and IMTCCAl r=−0.57, both P<0.001, independently of age, BMI, waist circumference, blood pressure, triglycerides, LDL cholesterol and HDL cholesterol. According to the median level of M 6.118 mg/kg per min of NGT subjects, T2D pts were divided into insulin sensitive (IS) and insulin resistant (IR). There was a significant difference between IMTCCAl 0.87±0.20 of IR pts and IMTCCAl 0.62±0.23 of IS pts, P<0.01. There was a significant difference in CIMT between IR pts and NGT subjects, whereas we did not find a significant difference in CIMT between IS pts and control group.

Conclusion: Insulin resistance could be considered as an important factor for increased carotid intima media thickness in type 2 diabetic patients.

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