Characteristics of carotid atherosclerosis in elderly patients with type 2 diabetes at different disease course, and the intervention by statins in very elderly patients

Abstract

Introduction: Chronic complications of diabetes have become the leading cause of death in elderly patients with diabetes. Carotid atherosclerosis, one of the major complications, was evaluated and the effects of atorvastatin on carotid atherosclerosis in very elderly patients with type 2 diabetes were observed. Materials and Methods: Patients were divided into three groups: (i) disease course <5 years; (ii) disease course 5–10 years; (iii) disease course >10 years, and carotid atherosclerosis was evaluated. The very elderly patients were treated with statins, and the effect was observed. Results: Carotid intima-media thickness values, plaque instability and levels of homocysteine, cystatin, and C-reactive protein in diabetes patients were significantly higher than those in the healthy control group, whereas levels of C-peptide and estimated glomerular filtration rate in the patients were significantly lower. In patients with type 2 diabetes for >10 years, intima-media thickness values and plaque instability were obviously higher than those in patients with type 2 diabetes for <5 years, while levels of fasting C-peptide and estimated glomerular filtration rate were lower than those in patients with type 2 diabetes for <5 years. In the very elderly patients, after statins treatment, intima-media thickness values, levels of homocysteine and C-reactive protein were significantly reduced, as well as the number of unstable plaques. Conclusions: In the elderly patients with type 2 diabetes, carotid atherosclerosis-related factors increased obviously, and renal function declined obviously, which were closely related to the disease course. Atorvastatin significantly reduced homocysteine and C-reactive protein, and delayed and reversed the progress of carotid atherosclerosis in very elderly patients with type 2 diabetes.