Associations of Carotid Atherosclerosis in Type 2 Diabetic Out-Patients in a Tertiary Health Facility in South-Eastern Nigeria: A Cross-Sectional Study

Abstract

<i>Background: </i>Carotid atherosclerosis (CA) characterized by the thickening of the endothelium of the carotid arteries, is a reflection of generalized atherosclerosis and a surrogate for cardiovascular events.<i> Objectives: </i>To determine the prevalence and associated risk factors for CA in asymptomatic type 2 diabetes mellitus (T2DM) out-patients at NAUTH in Nnewi, Nigeria.<i> Materials and Methods: </i>This was a cross-sectional study that evaluated 142 T2DM out-patients. Relevant data was extracted with a researcher-structured questionnaire. Anthropometric measurements, glycated haemoglobin and fasting lipid profile were done. Carotid intima-media thickness was measured using ultrasongraphy. Ultrasonography of the brachial and pedal arteries was done using ultrasonic pocket doppler device and ankle brachial pressure index calculated. Lastly, the vibration perception threshold was determined using a digital biothesiometer. Data was analyzed using SPSS version 25. Results of categorical variables were presented in tables as frequencies and percentages. The mean values and standard deviation for the continuous variables were calculated. Chi-square test was used to assess the association between CA and categorical variables. The level of significance was set at p < 0.05.<i> Results: </i>The mean age of the 142 subjects was 59.15 ± 11.37 years and the gender distributions comprised 57.7% female and 42.3% male subjects, respectively. The prevalence of CA among the subjects was 49.3% and CA showed significant associations with educational level (X<sup>2</sup> = 10.460; p = 0.015), exercise status (X<sup>2</sup> = 5.060; p = 0.024), abdominal obesity in male (X<sup>2</sup> = 4.659; p = 0.031) and the female subjects, respectively (X<sup>2</sup> = 8.874; p = 0.003), and also with diabetic peripheral neuropathy (DPN) (X<sup>2</sup> = 8.158; p = 0.004).<i> Conclusion: </i>The prevalence rate of CA was high and depicted a huge burden of cardiovascular morbidities in T2DM subjects. Equally, CA showed significant associations with educational level, exercise, diabetic peripheral neuropathy and abdominal obesity in subjects.