Plasma Insulin and Carotid Intima Media Thickness in Hypertensive and Non Hypertensive Type 2 Diabetics
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- Category: Vol. 78, June 2010
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Plasma Insulin and Carotid Intima Media Thickness in Hypertensive and Non Hypertensive Type 2 Diabetics,ASSEM SAIF, MAHMOUD MAHFOUZ, RATEBA ABDELAL andASHRAF MOHAMAD
Abstract
Diabetes mellitus and hypertension are two commonly co-existing diseases which are associated with evidence of endothelial dysfunction and atherosclerosis. Arterial IMT measured by high resolution B-mode ultrasound is a non-invasive indicator of the extent of generalized atherosclerosis. There is evidence that, at vascular level, carotid IMT is increased before the onset of diabetes type 2. Increased carotid IMT over a 2 years period was linked to age, LDL cholesterol and smoking but not to blood pressure levels. A few studies found no difference in IMT between hypertensive and normo-tensive subjects. On the other hand, many other studies demonstrated increased carotid IMT in hypertensive population more than normotensives. The purpose of our present study is to clarify the relation between carotid IMT as a predictor of atherosclerosis in hypertensive versus nonhypertensive diabetic patients. In this study, we examined 64 individuals. They were divided into 3 groups, 32 diabetic hypertensives, 22 diabetic nonhypertensives and 10 healthy individuals as a control group. High resolution B-mode ultrasonography (7.5 MHz) was carried out for all individuals under study 0.5 to 1 cm proximal to carotid bulb by a well trained sonographer.
Results: The mean value of IMT was 1.08±0.4mm for hypertensives and 0.85±0.2mm for nonhypertensive diabetic subjects (p<0.001), whereas, in control subjects, it was 0.4±0.06mm. A positive correlation was found between IMT and age in all patients (p<0.05) while, insignificant correlation was found between IMT and LDL cholesterol in all patients. Negative correlation was found between IMT and HDL in all patients. There was a statistically significant difference as regards fasting serum insulin in hypertensive Vs nonhyeprten-sive diabetics with a mean value of 11.8±9.5u/L for hyperten-sive and 9.4±8.6u/L for nonhypertensives (p<0.005).