%0 Journal Article
%T Carotid Atherosclerosis as a Surrogate Maker of Cardiovascular Disease in Diabetic Patients
%A Ryuichi Kawamoto
%A Tateaki Katoh
%A Tomo Kusunoki
%A Nobuyuki Ohtsuka
%J ISRN Endocrinology
%D 2013
%R 10.1155/2013/979481
%X Many studies have shown that carotid intima-media thickness (IMT) is associated with cardiovascular disease (CVD). Although it remains inconclusive whether assessment of carotid IMT is useful as a screening test for CVD in Japanese diabetic patients, a total of 271 patients (151 men aged 66 ¡À 10 (standard deviation) years and 220 women aged 71 ¡À 8 years) were divided into two groups based on the presence of CVD. We cross-sectionally assessed the ability of carotid IMT to identify CVD corresponding to treatment that was examined by receiver-operating characteristic (ROC) curve analyses. Among the 271 diabetic patients, 199 non-CVD and 72 CVD patients were examined. Multiple linear regression analysis using the presence of CVD as an objective variable showed that carotid IMT ( , ) as well as other confounding factors was a significant independent contributing factor. The ROC curve analysis showed that the best marker of CVD was carotid IMT, with an area under the ROC curve of 0.718 (95% confidence interval (CI), 0.650¨C0.785). The greatest sensitivity and specificity were obtained when the cut-off value of mean carotid IMT was set at 0.95£¿mm (sensitivity = 0.71, specificity = 0.60, and accuracy = 0.627). Our study suggests that carotid IMT may be useful for screening diabetic patients with CVD. 1. Introduction Diabetes is associated with a high risk of cardiovascular disease (CVD) which is the most common cause of mortality in people with diabetes. CVD accounts for more than 70% of deaths in people with diabetes [1]. A two- to fourfold increased risk of CVD in people with diabetes compared without diabetes has been reported by various research groups [2¨C4]. Carotid intima-media thickness (IMT) can now be measured noninvasively by B-mode ultrasonography and is an important and sensitive surrogate marker of cardiovascular disease (CVD). A lot of evidence has shown close associations between this parameter and conventional cardiovascular risk factors, including age, obesity, smoking status, hypertension, and dyslipidemia including hypertriglycerides, low high-density lipoprotein cholesterol (HDL-C) level, increased low-density lipoprotein cholesterol (LDL-C) level, and diabetes [5, 6]. In prospective studies, carotid IMT predicted clinical CVD events independently of traditional risk factors [7¨C10]. Recent findings have suggested that IMT measurements can be used to stratify patients into high-risk groups [11], but meta-analyses have found that carotid IMT is not predictive of cardiovascular events [12, 13], and in 2010 the American Heart Association and the
%U http://www.hindawi.com/journals/isrn.endocrinology/2013/979481/