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Preclinical Atherosclerosis and Inflammation in 61-Year-Old Men With Newly Diagnosed Diabetes and Established Diabetes

From the Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Göteborg University, Gothenburg, Sweden

Address correspondence and reprint requests to Vilborg Sigurdardottir, Wallenberg Laboratory, Physiology Group, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden. E-mail: vilborg{at}wlab.wall.gu.se

OBJECTIVE—The aim of this study was to investigate the occurrence of subclinical atherosclerosis and underlying mechanisms in men with newly diagnosed diabetes and established diabetes compared with healthy control subjects.

RESEARCH DESIGN AND METHODS—In a population-based study of 61-year-old Caucasian men (n = 271) with established diabetes (n = 50) and newly diagnosed diabetes (n = 24) and healthy control subjects (n = 197), standard risk factors and highly sensitive (hs) C-reactive protein (CRP) were measured. Ultrasound measurements of intima-media thickness (IMT) were performed bilaterally in the common carotid artery, and a composite measure was calculated from common carotid and carotid bulb IMT (composite IMT). The plaque status was assessed.

RESULTS—Composite IMT and carotid plaque size increased gradually among the healthy control subjects, newly diagnosed diabetic patients, and established diabetic patients (P for trend 0.001, respectively). CRP was higher in newly and established diabetes (NS between diabetes groups) compared with healthy control subjects (P < 0.001). Total cholesterol levels were lower in newly diagnosed diabetes (5.51 ± 1.13 mmol/l, P < 0.05) and established diabetes (5.45 ± 1.15 mmol/l, P < 0.01) compared with those of healthy control subjects (5.77 ± 1.03 mmol/l). In men with diabetes (n = 74), diabetes onset status (newly diagnosed versus established), waist-to-hip ratio (WHR), and serum triglycerides, but not CRP, explained 16% of the variance in composite IMT.

CONCLUSIONS—This is the first study to show increased preclinical atherosclerotic changes (IMT and plaque size) and increased inflammation (hs-CRP) in men with newly diagnosed diabetes as well as in patients with established diabetes compared with healthy control subjects. WHR, diabetes onset status (newly diagnosed versus established), and triglycerides, but not CRP, were independent correlates of carotid artery IMT in men with diabetes.

Abbreviations: CCA, common carotid artery • CRP, C-reative protein • FPG, fasting plasma glucose • hs, highly sensitive • IMT, intima-media thickness • OGTT, oral glucose tolerance test • WHR, waist-to-hip ratio

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