An Observational Case Control Study to Assess the Carotid Intima-media Thickness with Lipid Profile among Type 2 Diabetics

Background: Type 2 diabetes Mellitus (T2DM) and dyslipidemia work synergistically to cause increased intima-media thickness (IMT), atherosclerosis, plaque formation and subsequent acute vascular events. Relating IMT to serum cholesterol levels in our environment can help in predicting patients at risk of plaque formation. Materials and Methods: Ultrasound of both carotid bulbs and the common carotid arteries were carried out on T2DM patients and controls using ultrasound machine with high frequency linear transducer. Fasting serum cholesterols were collected and estimated. The data was analysed using SPSS version 25.0. Descriptive analysis, crosstabulation, independent samples t-tests, and Pearson correlation tests were carried out. P values ≤ 0.05 were considered statistically significant. Results: There is dyslipidemia in 90.4% of the T2DM group, with 87.7% of the patients with dyslipidemia having reduced high density lipoproteins(HDL). Significant difference in means is noted between T2DM patients and the controls with regards to serum total cholesterol(TC) (P=0.04), triglyceride(TG) (P = 0.011), HDL (P = 0.019), but not with low density lipoproteins (LDL) (P = 0.694). IMT was thickened in 89.0% of the T2DM group; CIMT was significantly thicker among the cases in all the measured carotid vessels (P ≤0.05). Atheromatous plaque was present in 46.9% of the T2DM patients with CIMT thickening. No plaque was seen in the control group but 44.6% of the cases had plaques. Among those with plaques, IMT was thickened in 90.9%, while both dyslipidemia and thickened IMT were present in 87.9%. There was significant correlation between RtCCAIMT vs HDL(P = 0.040), LtCCAIMT vs LDL(P = 0.050), and between LtCB vs LDL(P = 0.025), but not between the lipid profile and the size of the largest plaque. Conclusion: The findings support the utility of ultrasonographic measurement of CIMT as a means of early cardiovascular risk assessment in T2DM patients with dyslipidemia.