Microvascular complications of type 2 diabetes mellitus are associated with plaque score in the carotid arteries

INTRODUCTION: According to the "common soil" hypothesis, diabetic microangiopathy and macroangiopathy have a similar pathophysiological background. It has been well documented that carotid artery atherosclerosis in patients with type 2 diabetes is associated with cardiovascular complications; however, it remains unclear whether there is a similar association for microvascular complications. OBJECTIVES: We investigated whether the carotid plaque score and the carotid intima-media thickness (IMT) are associated with macroangiopathic and microangiopathic complications of type 2 diabetes. PATIENTS AND METHODS: We enrolled patients with type 2 diabetes and microvascular complications or overt macroangiopathy. A B‑mode carotid ultrasound was performed in all participants, and anthropometric parameters, hemoglobin A1c (HbA1c) levels, lipid profile, and smoking status were assessed. RESULTS: The study included 73 patients (mean [SD] age, 63.6 [7.5] years; 36 men [49%]). The mean (SD) diabetes duration was 11.7 (8.1) years. Microvascular complications were observed in 32 patients (43.8%), and overt macroangiopathy, in 42 (57.5%). Hypertension was reported for 60 patients (82%); dyslipidemia, for 56 (77%); obesity, for 37 (51%); and smoking, for 10 (14%). A multivariate regression analysis showed that the carotid plaque score, but not carotid IMT, was significantly associated with dyslipidemia (P = 0.03) and microangiopathy (P = 0.01). CONCLUSIONS: Our results indicate that, unlike carotid IMT, the carotid plaque score is independently associated with microangiopathic complications in type 2 diabetes. Patients with a high plaque score should receive special care and the most intensive treatment to stop progression of these complications.