The purpose of this study was to examine the associations of carotid artery intima-media wall thickness (IMT) with hemostatic proteins and cardiovascular risk factors (CVRFs) in participants with and without non- insulin dependent diabetes mellitus (NIDDM). IMT measurements were determined by high resolution B-mode ultrasound imaging of the carotid arteries in 921 participants with NIDDM and 11 964 non-diabetic participants aged 45-64 years. Fasting glucose, serum lipids and activated partial thromboplastin time, factor VIII fibrinogen, factor VII, antithrombin III, protein C, and von Willebrand factor measurements were made. Compared to non-diabetic participants, participants with NIDDM had a more adverse pattern of CVRFs and a more procoagulatory profile. Participants with NIDDM had 0.06 mm (8.1%) higher mean IMT compared to non-diabetic participants after adjusting for age and gender (P<0.001). However, only plasma fibrinogen concentrations showed statistically significant positive associations with IMT in both groups. After adjusting for CVRFs and fibrinogen, mean IMT remained 0.04 mm (5.4%) higher in diabetic compared to non-diabetic participants. Despite the more procoagulatory profile in participants with NIDDM, only plasma fibrinogen concentrations were independently associated with mean IMT. The association of NIDDM with mean IMT was only partly explained by CVRFs.
Bibliographical noteFunding Information:
Support was provided by National Heart, Lung, and Blood Institute Contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. This research was carried during the tenure of an Overseas Research Fellowship of the Health Research Council of New Zealand by P. Metcalf. The authors thank the staff at the ARIC centers: University of North Carolina, Chapel Hill, NC—Phyllis Johnson, Marilyn Knowles, and Catherine Paton; University of North Carolina, Forsyth County—Shirley Cothern, Amy Haire, Kim Jones, and Delilah Posey; University of Mississippi Medical Center, Jackson—Virginia Overman, Stephanie Parker, Liza Sullivan, and Cora Walls; University of Minnesota, Minneapolis—Gerda Nightingale, Carmen O'Donnell, Evie Onnen, and Leone Reed; John Hopkins University, Baltimore-Carol Christman, Maryann CoccodriUi, Dorie Costa, and Patricia Crowley; University of Texas Medical School, Houston—Valarie Stinson, Pam Pfile, Hogan Pham, and Teri Trevino; The Methodist Hospital, Atherosclerosis Clinical Laboratory, Houston—Wanda R. Alexander, Doris J. Harper, Charles E. Rhodes, and Selma M. Soyal; Bowman-Gray School of Medicine, Ultrasound Reading Center, Winston-Salem—Suzanne Pillsbury, Tiffany Robertson, Anne Safrit, and Melanie Wilder; University of North Carolina, Chapel Hill, Coordinating Center-W. Brian Stewart, Chimmon Walker, Louis Wijnberg, and Kiduk Yang.
- B-mode ultrasound
- Carotid atherosclerosis
- Plasma fibrinogen