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Randomized Controlled Trial
. 2020 Oct;34(10):107681.
doi: 10.1016/j.jdiacomp.2020.107681. Epub 2020 Jul 18.

Prediction of carotid intima-media thickness and its relation to cardiovascular events in persons with type 2 diabetes

Karoline Winckler  1 , Birger Thorsteinsson  2 , Niels Wiinberg  3 , Andreas Kryger Jensen  4 , Louise Lundby-Christensen  5 , Berit Lilienthal Heitmann  6 , Søren S Lund  7 , Thure Krarup  8 , Tonny Jensen  9 , Henrik Vestergaard  10 , Leif Breum  11 , Simone Sneppen  12 , Trine Boesgaard  13 , Sten Madsbad  14 , Christian Gluud  15 , Allan Vaag  16 , Thomas P Almdal  9 , Lise Tarnow  17 ; CIMT trial group
Affiliations
Randomized Controlled Trial

Prediction of carotid intima-media thickness and its relation to cardiovascular events in persons with type 2 diabetes

Karoline Winckler et al. J Diabetes Complications. 2020 Oct.

Abstract

Aims: To investigate measures of carotid intima-media thickness (IMT) and conventional cardiovascular (CV) risk factors as predictors of future carotid IMT, and the prediction of CV events during follow-up based on measures of carotid IMT.

Methods: Observational longitudinal study including 230 persons with type 2 diabetes (T2D).

Results: Mean age at follow-up was 66.7 (SD 8.5) years, 30.5% were women and mean body mass index (BMI) was 31.8 (4.4) kg/m2. Carotid IMT was measured at baseline, after 18 months of intervention in the Copenhagen Insulin and Metformin Therapy (CIMT) trial and after a mean follow-up of 6.4 (1.0) years. Baseline carotid IMT, carotid IMT after 18 months' intervention, and CV risk factors (age, sex and baseline systolic blood pressure) gave the best prediction of carotid IMT (root mean-squared error of prediction of 0.106 and 95% prediction error probability interval of -0.160, 0.204).

Conclusions: Measures of carotid IMT combined with CV risk factors at baseline predicts attained carotid IMT better than measures of carotid IMT or CV risk factors alone. Carotid IMT did not predict CV events, and the present results do not support the use of carotid IMT as a predictor of CV events in persons with T2D.

Keywords: Ageing; Atherosclerosis; Cardiovascular disease; Cardiovascular risk factors; Carotid intima-media thickness; Prediction; Type 2 diabetes.

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Conflict of interest statement

Declaration of competing interest All authors have completed the ICMJE uniform disclosure form at. www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: the trial received an unrestricted grant from Novo Nordisk A/S for the submitted work. LLC, LT, TPA, AV, TWB, SSL, TJ have reported shares in Novo Nordisk A/S; LLC, LT, TPA, AV, TWB, SSL have reported former employment at Steno Diabetes Center, which is a diabetes hospital and academic institution owned by Novo Nordisk; SSL is employed at Boehringer Ingelheim Pharma GmbH & Co. KG; SSL's contribution was his alone and does not necessarily reflect the official position of Boehringer Ingelheim. AV has received fees from Novo Nordisk and is employed at AstraZeneca A/S; TWB is employed at Novo Nordisk A/S; BT is member of advisory board for Eli Lilly; LB has received fees from and attended advisory for Novo Nordisk A/S; SM has served as a consultant or adviser to: Novartis Pharma, Novo Nordisk, Merck Sharp & Dome, Sanofi-Aventis, AstraZeneca, Johnson & Johnson, Rosche, Mankind, Astra-Zeneca, Boehringer-Ingelheim, Zeeland, E Lilly, Intarcia Therapeutics, Bristol-Meyer Squibb, has received fee for speaking from Novo Nordisk, Merck, Sharp & Dome, Astra-Zeneca, Johnson and Johnson, Rosche, Shering-Ploug, Sanofi-Aventis, Novartis Pharma, E Lilly, Bristol-Meyer Squibb, Boehringer Ingelheim, and has received 2 research grants from Novo Nordisk. The remaining authors declare no conflict of interest.

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