Correlation of Postprandial Hypertriglyceridemia with Carotid Intima Media Thickness in Patients with Type 2 Diabetes Mellitus

Abstract

Introduction: Macro vascular disease is a major cause of death in diabetic individuals. Because many diabetic individuals have multiple risk factors for atherosclerosis, the relative risks of Ischemic Heart Disease (IHD) and Cerebro-Vascular Disease (CVD) are 2-4 fold and 2-3 fold higher respectively, than the risk in non-diabetic subjects. Several studies indicate that postprandial metabolic derangements, most notably hyperglycemia and hypertriglyceridemia are important cardiovascular risk factors since they induce oxidative stress and endothelial dysfunction. Measurement of Carotid Intima Media Thickness (CIMT) by ultrasonography is a non-invasive and quantitative method of evaluating early atherosclerotic changes in the vasculature. It has been shown that an increase in CIMT is associated with an increased risk of IHD or CVD. Aim: The present study was undertaken to find the correlation of postprandial hypertriglyceridemia with carotid intima media thickness in North Indian patients with type II Diabetes Mellitus. Materials and Methods: The present study was done amongst 50 North Indian patients, between the age group of 35-75 years suffering from Type II Diabetes Mellitus for less than 1 year duration. All routine investigations and special investigations like Lipid Profile (Fasting)-total Cholesterol, HDL, LDL, Triglycerides, VLDL, Lipid profile {Postprandial (4 hours after a standard meal)} - Triglycerides, B- mode ultrasonography of common carotid artery were done in all the patients. An attempt was made to find the correlation between postprandial hypertriglyceridemia with carotid intima media thickness. Results: Both PPTG and FTG showed a strong correlation with CIMT, the correlation coefficients being 0.879 and 0.764 respectively. If the subjects with normal FTG were taken to calculate correlation between PPTG and CIMT, correlation coefficient was 0.848 and if only the subjects with raised FTG were taken then the correlation coefficient was 0.735; suggesting a stronger correlation of PPTG with CIMT at normal fasting triglyceride levels. Conclusion: Both, increased postprandial triglyceride levels and fasting triglyceride levels are risk factors for increasing carotid intima media thickness in patients with Type II Diabetes Mellitus.

Keywords

• atherosclerosis
• coronary heart disease
• ischemic heart disease