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Control of cardiometabolic risk factors and their association with carotid intima media thickness among patients with type 2 diabetes mellitus-single center experience in a developing country.
Weerarathna, Thilak Priyantha; Lekamwasam, Sarath; Kodikara, Iroshani; Wasana, Keddegoda Gamage Piyumi; Fonseka, Lakmal.
Afiliación
  • Weerarathna TP; Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
  • Lekamwasam S; Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
  • Kodikara I; Department of Anatomy, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
  • Wasana KGP; Diabetes Centre, Cooperative Hospital, Galle, Sri Lanka.
  • Fonseka L; Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Turk J Med Sci ; 54(3): 545-554, 2024.
Article en En | MEDLINE | ID: mdl-39050007
ABSTRACT
Background/

aim:

Type 2 diabetes mellitus (T2DM) is closely associated with atherosclerotic cardiovascular diseases (ASCVD). The objective of this study was to describe the degree of ASCVD risk factor control and their association with carotid intima-media thickness (CIMT) in T2DM patients followed up at a diabetes clinic in Southern, Sri Lanka. Materials and

methods:

A crosssectional study was conducted to examine the association between CIMT and nonalcoholic fatty liver disease (NAFLD)in 300 T2DM patients. Both CIMT and its associations with modifiable cardiometabolic risk factors were examined using ultrasonography. The recommended optimal targets for risk factors were defined as glycated hemoglobin (HbA1C) < 7 %, absence of NAFLD, albumin-to-creatinine ratio (ACR) < 30 mg, triglyceride (TG) < 150 mg/dL, low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, high-density lipoprotein cholesterol (HDL-C) in men > 40 and in women > 50 mg/dL, systolic blood pressure (SBP) < 130 mmHg, and diastolic blood pressure (DBP) < 80 mmHg.

Results:

SBP, DBP, LDL-C, TG, HDL-C, HbA1C, and ACR were optimally controlled in 59.3%, 75.0%, 46.7%, 84.3%, 46.0%, 33.0%, and 18.7% of patients, respectively. Notably, nearly half of the study subjects did not have NAFLD. Only three patients (1%) had achieved all therapeutic targets. There were statistically significant differences in CIMT between optimally controlled TG and suboptimally controlled TG group (p = 0.027) and between the groups with and without NAFLD (p = 0.045) when adjusted for age and duration of diabetes. CIMT showed significant and positive associations with LDL-C (p = 0.024), TG (p = 0.026), and NAFLD (p = 0.005). Among these, the presence of NAFLD had the highest odds of having higher CIMT when compared to LDL-C and TG.

Conclusion:

The majority of patients have not achieved the recommended targets for ASCVD risk factors and are at high risk of ASCVD. It is therefore necessary to identify the reasons for not achieving the treatment targets in order to reduce the ASCVD burden by controlling LDL-C, TG, and NAFLD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 2 / Grosor Intima-Media Carotídeo / Factores de Riesgo Cardiometabólico Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Turk J Med Sci Año: 2024 Tipo del documento: Article País de afiliación: Sri Lanka Pais de publicación: Turquía

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 2 / Grosor Intima-Media Carotídeo / Factores de Riesgo Cardiometabólico Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Turk J Med Sci Año: 2024 Tipo del documento: Article País de afiliación: Sri Lanka Pais de publicación: Turquía