Carotid intima-media thickness in Japanese type 2 diabetic subjects: Predictors of progression and relationship with incident coronary heart disease

Abstract

OBJECTIVE - To examine carotid intima-media thickness (IMT), predictors of its progression, and its relationship with incident coronary heart disease (CHD) in type 2 diabetic Japanese patients. RESEARCH DESIGN AND METHODS - Carotid IMT of 287 subjects with type 2 diabetes (mean age 61.6 years) without CHD or cerebrovascular disease was examined at baseline and after a mean follow-up of 3.1 years. RESULTS - The annual progression of IMT (means ± SEM) was 0.04 ± 0.004 mm/year. Stepwise multivariate analysis demonstrated that independent risk factors for progress of IMT were the initial IMT (P < 0.001), the average HbA(1c) level (P < 0.001), and age (P = 0.001). Both the initial IMT (odds ratio [OR] 4.9, 95% Cl 1.7-14.1) and a low average HDL cholesterol (OR 0.2, 0.1-0.8) were identified as predictors of incident nonfatal CHD (angina pectoris or nonfatal myocardial infarction; 3-year incidence 10.1%) after adjusting for age, sex, average HbA(1c), and other risk factors. CONCLUSIONS - The predictors of the progression of carotid IMT in Japanese type 2 diabetic subjects were its baseline thickness and the average HbA(1c) during the follow-up. Baseline carotid IMT and low HDL cholesterol predicted the incidence of nonfatal CHD.