Relationship between plasma adipokines, inflammation, insulin resistance and subclinical atherosclerosis in newly diagnosed type 2 diabetes

Background: The aim of this study was to investigate the occurrence of subclinical atherosclerosis, evaluated by carotid artery intimamedia thickness (CIMT) in subjects with newly diagnosed type 2 diabetes. Methods: A total of 167 subjects, 50 newly diagnosed type 2 diabetic subjects and 117 non-diabetic subjects were included in the study. Obese and overweight newly diagnosed type 2 diabetic patients were matched for age and BMI with obese and overweight non-diabetic subjects. Only postmenopausal women were selected. The following biomarkers were analyzed: fasting glucose, HbA1c, fasting insulin, fasting proinsulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, adiponectin, leptin, hs-CRP, urine albumin/creatinine ratio. 75 g oral glucose tolerance test was performed in all subjects. Ultrasound imaging was used to evaluate IMT of the common carotid artery. Results: CIMT was greater in newly diagnosed type 2 patients compared to non-diabetic subjects. When analyzed by BMI, the difference regarding CIMT between diabetic and non-diabetic subjects was significant only in overweight subjects, in both sexes. In univariate analysis in men with newly diagnosed type 2 diabetes, CIMT was positively correlated with age, SBP, triglycerides, leptin and negatively correlated with HDL-cholesterol and in women CIMT was positively correlated with SBP and leptin. Independent determinants of CIMT in patients with newly diagnosed type 2 diabetes were in men age (β = 0.556, p = 0.0028) and log leptin (β = 0.393, p = 0.049) and in women systolic blood pressure (β = 0.48, p = 0.026). Conclusions: Subclinical atherosclerosis is present in newly diagnosed type 2 diabetic subjects. Body fat accumulation in men and hypertension in postmenopausal women have a primary role in increase carotid intima-media thickness.