Is insulin resistance an independent risk factor for atherosclerosis in type 2 diabetes ?

Abstract EN

In the present study, we aimed to assess the effects of candidate atherosclerosis risk factors including plasma insulin and insulin resistance on carotid artery intimal -medial thickness (IMT) as an early marker for atherosclerosis in 30 type 2 diabetes patients as well as in 30 age and sex matched nondiabetic subjects.

In both groups, IMT was measured by B-mode ultrasonography while candidate atherosclerosis risk factors were also measured.

Insulin sensitivity and reciprocally insulin resistance was assessed by calculating plasma glucose disappearance rate after intravenous insulin injection (Kitt).

Our results showed that IMT was significantly higher in diabetics compared to nondiabetics (1.36 ± 0.28 mm versus 1.14 ±0.21 mm, P<0.005).

Of all candidate risk factors body mass index systolic blood pressure, fasting insulin, as well as the frequency of hypertension and dyslipidemia were significantly higher in diabetic patients.

Importantly, Kitt was significantly lower in diabetics compared to non diabetics (3.84 ± 0.99 % / minute versus 6.95 ± 0.81% / minute, P<0.001), indicating lowered insulin sensitivity and reciprocally increased insulin resistance.

Simple regression analysis revealed significant negative correlation betM’een IMT and Kitt in either diabetics (r = - 0.66, P < 0.01) or nondiabetics (r = -0.63, P < 0.01).

Stepwise multiple regression analysis showed independent association between IMT and both body mass index and waist-to-hip ratio in diabetics as well as in nondiabetics, while IMT was independently associated with Kitt only in diabetics.

Plasma insulin was not independently associated with IMT in both groups.

Our results indicate that type 2 diabetes is characterized by greater thickness of the carotid artery, and that atherosclerosis is independently.