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4B.06: EFFECT OF CHRONIC KIDNEY DISEASE, DYSLIPIDEMIA AND HYPERTENSION ON CAROTID ATHEROSCLEROSIS IN ELDERLY PATIENTS WITH TYPE 2 DIABETES

Objective: To assess the possible role of dyslipidemia, hypertension and chronic kidney diseases on the characteristics of carotid atherosclerosis in elderly patients with type 2 diabetes (DT2). Design and method: We investigated 76 patients both sexes with DT2 aged 65.54 ± 4.37 years (from 60 to 75 years). Control group included 24 healthy subjects the same age. The intima-media thickness (IMT) was measured as the distance between the lumen-intima interface and the media-adventitia interface. Atherosclerotic plaque was defined as a focal structure encroaching into the arterial lumen of 0.5 mm or 50% of the surrounding IMT value. Total plaque area (TPA) was calculated as the sum of all plaque areas. Results: The mean blood glucose and HbA1c level were 8.52 ± 3.10 mmol/L and 6.59 ± 1.88%, respectively. We divided all patients into 3 groups: Group 1 (n = 24) – patients did not have any additional atherosclerosis risk factor, Group 2 (n = 25) – patients had one additional atherosclerosis risk factor, and Group 3 (n = 43) – patients had two or three additional atherosclerosis risk factors. Using multiple linear regression analysis adjusted for confounding factors, IMT and TPA were significantly correlated with age > 60 years (p < 0.0001; p < 0.0001), hypertension (p = 0.003; p < 0.0001), dyslipidemia (p = 0.0001; p < 0.0001) and CKD (p = 0.003; p < 0.0001), respectively. However, gender (men) was not significantly correlated with IMT (p = 0.171) and TPA (p = 0.112). We found a significant difference in carotid IMT between left and right carotid artery (0.70 ± 0.16 mm versus 0.66 ± 0.13 mm, p < 0,001, respectively). There were no significant difference in carotid IMT between patients with plague and without plague (p = 0.171). Conclusions: We showed the role of additional atherosclerosis risk factors to carotid atherosclerosis in elderly patients with DT2. In these patients, the presence of dyslipidemia, hypertension, and different CKD status were predictors of carotid plaque.