Evaluation of common carotid artery in type 1 diabetes mellitus patients through speckle tracking carotid strain ultrasonography

Özet

PURPOSEWe aimed to evaluate the effectiveness of speckle tracking carotid strain (STCS) technique,which enables measurement of arterial stiffness and strain parameters, in the detection ofearly atherosclerotic findings in type 1 diabetes mellitus (T1DM).METHODSWe prospectively enrolled 30 T1DM patients and 30 age- and sex-matched control participants with no history of cardiovascular disease. All study population underwent carotid ultrasonography. Radial and circumferential movement of the common carotid artery (CCA) inthe transverse plane as the well as the radial movement of the CCA in the longitudinal planewere calculated automatically by using the STCS method. In addition, the strain (%), strainrate (per second), and peak circumferential and radial displacements (mm) were calculated.Arterial stiffness parameters, such as elastic modulus, distensibility, arterial compliance, andβ-stiffness index, were calculated using the radial measurements. The mean value of the carotid intima media thickness (CIMT) was calculated semi-automatically for each CCA, in thelongitudinal plane. We also analyzed the patients’ overall body composition.RESULTST1DM and control groups were compared in terms of strain and stiffness parameters and nostatistically significant difference was found (p > 0.05). CIMT was higher in diabetic patientsthan in the control group (p = 0.039). In both groups, age was correlated with all arterialstiffness and strain parameters (p < 0.05). The duration of diabetes was also correlated withβ-stiffness index, distensibility, and elastic modulus in the longitudinal plane (p < 0.05). In thediabetic group, abdominal fat ratio, whole body fat ratio, and fat mass were correlated withradial and circumferential displacement and strain parameters in transverse plane, and radialdisplacement in longitudinal plane (p < 0.05, for each). Diabetic patients were divided intosubgroups according to the presence of nephropathy and dyslipidemia. Although no significant difference was found between the groups in terms of CIMT, patients with nephropathyhad higher values for transverse and longitudinal elastic modulus, pulse-wave velocity, andlongitudinal β-stiffness index, as well as lower values for longitudinal arterial compliance anddistensibility, compared with patients without nephropathy (p < 0.05). Also, patients withdyslipidemia had higher longitudinal β-stiffness and elastic modulus values compared withpatients without dyslipidemia (p < 0.05).CONCLUSIONSTCS ultrasonography is an effective, easy, and noninvasive method for evaluating the arterial elasticity. It may provide an early assessment of atherosclerosis in patients with T1DM,especially in the presence of nephropathy and dyslipidemia; thus, together with CIMT measurement, it may be used more frequently to detect subclinical damage and stratify atherosclerosis.