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Carotid artery remodeling could be adaptive mechanism in patients with type 2 diabetes
Increases in carotid intima-media thickness associated with glucose exposure could reveal an adaptive remodeling in patients with type 2 diabetes, according to research published in The Journal of Clinical Endocrinology & Metabolism.
The adaptation could serve to counteract a rise in pulsatile strain and to prevent increments in circumferential wall stress due to luminal enlargement of stiff arteries with hyperglycemia, according to researchers in Italy.
In a cross-sectional case-control study, Michaela Kozakova, MD, PhD, of the Department of Clinical and Experimental Medicine at the University of Pisa, and colleagues compared 133 patients with type 2 diabetes and 133 healthy controls to determine the relationships between chronic glucose exposure and arterial structure and function.
The patients with type 2 diabetes had no cardiovascular complications and the healthy controls had normal glucose metabolism; the groups were matched for sex, age and BMI.
The researchers evaluated carotid geometry and circumferential wall stress by measuring common carotid artery (CCA) intima-media thickness (IMT), luminal diameter, wave speed (WS) and local pulse pressure (PP).
Patients with type 2 diabetes demonstrated higher (P<.0001) CCA IMT (640±81 vs. 709±118 micrometer), luminal diameter (6.12±0.67 vs. 6.69±0.56 mm) and brachial PP (47±7 vs. 57±12 mmHg) compared with healthy controls. However, luminal radius to IMT ratio (4.8±0.7 vs. 4.8±0.8; P=.57) and circumferential wall stress (49±8.3 vs. 50.6±10.3 kilopascal; P=.26) were comparable between groups.
In patients with type 2 diabetes, glycosylated hemoglobin independently related to CCA WS and local PP; this was not the case in relation to IMT determined by age, local PP and luminal diameter.
“These observations suggest that the effect of hyperglycemia on carotid wall is prevalently ‘arteriosclerotic’ and that the glucose-related increase in carotid wall thickness might reflect, at least to a certain level, an adaptive remodeling aimed to mitigate increased pulsatile strain and preserve unchanged circumferential wall stress,” the researchers wrote.
Disclosures: The researchers report no relevant disclosures.