NEWLY TYPE 2 DIABETES MELLITUS: AN INDEPENDENT FACTOR OF INCREASED CAROTID STIFFNESS

Objective: Arterial stiffness serves as an indicator of the loss of elasticity in blood vessel walls and can be measured both centrally in the aorta and peripherally in the carotid artery. Increased stiffness in the carotid artery has been linked to a higher risk of cardiovascular disease, stroke, and cognitive impairment. This study aimed to evaluate carotid stiffness in patients with Type 2 Diabetes Mellitus (T2DM) one month after their diagnosis, free of treatment other than Metformin. Design and method: The study included patients with a recent diagnosis of T2DM and volunteers matched by age, blood pressure and LDL cholesterol. Laboratory tests and blood pressure measurements (office and 24-hour) were conducted. Carotid stiffness was measured using the beta-stiffness index, employing high-frequency ultrasound (7-12 mHz). Additionally, the 10-year cardiovascular risk (ASCVD Risk Score) was estimated. Results: A total of 75 individuals were studied: 29 patients with T2DM aged 56±11 years and 46 matched volunteers aged 55±10 years. Patients with T2DM exhibited an increased beta-stiffness index (9.25 ± 3.20 vs. 7.38 ± 2.65, p = 0.008). Overall, carotid stiffness was associated with: T2DM (r = 0.305, p = 0.008), hypertension (r = 0.298, p = 0.009), office systolic blood pressure (r = 0.298, p = 0.009), 24-hour systolic blood pressure (24SBP) (r = 0.241, p = 0.044), age (r = 0.248, p = 0.032), BMI (r = 0.307, p = 0.008), total cholesterol (r = 0.273, p = 0.021), LDL cholesterol (r = 0.273, p = 0.021), and with ASCVD Risk (r = 0.299, p = 0.001). After adjusting for age, sex, BMI, LDL, and 24SBP, the independent association of carotid stiffness with the recent diagnosis of T2DM (Beta: 0.279, p =0.016), LDL (Beta: 0.317, p = 0.006) and 24SBP (Beta: 0.237, p = 0.037) was confirmed. Conclusions: Carotid stiffness is already increased at the time of diagnosis in patients with T2DM, independent of the presence of other causal factors. The increased carotid stiffness highlights the multifaceted impact of T2DM on the disruption of normal physiology even at the early stages of the disease.