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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2003;23:1845.)
© 2003 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Elevated Carotid Artery Intima-Media Thickness Levels in Individuals Who Subsequently Develop Type 2 Diabetes

Kelly J. Hunt; Ken Williams; David Rivera; Daniel H. O’Leary; Steve M. Haffner; Michael P. Stern; Clicerio González Villalpando

From the Division of Clinical Epidemiology (K.J.H., K.W., S.M.H., M.P.S.), Department of Medicine, University of Texas Health Science Center at San Antonio; Centro de Estudios en Diabetes (D.R., C.G.V.), The American-British Cowdray Medical Center, Mexico City, Mexico; the Department of Radiology (D.H.O’L.), Tufts–New England Medical Center, Boston, Mass; and Unidades de Investigación Médica en Enfermedades Metabólicas y Epidemiología Clínica (C.G.V.), Hospital Gabriel Mancera, Instituto Mexicano del Seguro Social, Mexico City, Mexico.

Correspondence to Kelly J. Hunt, PhD, Division of Clinical Epidemiology, UTHSCSA, 7703 Floyd Curl Dr, San Antonio, TX 78229[hyphen]3900. E-mail huntk{at}uthscsa.edu

Objective— We examined whether B-mode ultrasound–detected carotid artery intima-media thickness (IMT) was elevated before the onset of clinical diabetes.

Methods and Results— The study population for these analyses included 1127 nondiabetic participants, 66 prediabetic participants, and 303 diabetic participants with a mean age of 49.8 years who participated in the Mexico City Diabetes Study, a prospective cohort study. Common carotid artery (CCA) and internal carotid artery (ICA) IMTs were measured bilaterally by B-mode ultrasound. Age- and sex-adjusted mean ICA and CCA IMTs were both significantly higher among prediabetic individuals {0.81 mm [95% confidence interval (CI), 0.75–0.88] and 0.72 mm [95% CI, 0.69–0.75], respectively} than in individuals who remained free of diabetes [0.71 mm (95% CI, 0.69–0.72) and 0.69 mm (95% CI, 0.68–0.69), respectively]. However, after adjustment for established cardiovascular risk factors, ICA IMT, but not CCA IMT, remained significantly higher among prediabetic individuals [0.81 mm (95% CI, 0.75–0.88) and 0.71 mm (95% CI, 0.68–0.74)] than in individuals who remained free of diabetes [0.71 mm (95% CI, 0.69–0.72) and 0.69 mm (95% CI, 0.68–0.70)].

Conclusions— The present study provides direct evidence at the vascular level that atherosclerosis levels are elevated before the clinical onset of diabetes.

Key Words: atherosclerosis • carotid arteries • imaging • diabetes mellitus

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