Early predictors of carotid atherosclerosis in patients with type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) promotes a risk of the development of atherosclerosis and potentiates atherosclerotic cardiovascular events. Among these patients, chronic hyperglycemia, dyslipidemia, oxidative stress and systemic inflammation has been found as triggers for accelerating plaque formation. Additionally, conventionally used risk factors, such as age, overweight/obesity, hypertension, poor glycemic control, renal dysfunction, and metabolic disturbances frequently underestimate the patients at the risk of asymptomatic carotid atherosclerosis. Further interventions may be required to prevent vascular complications. To note, asymptomatic carotid plaque in T2DM is associated with older age, increased body mass index, biomarkers of poor glycemic control (glycated hemoglobin, fasting glucose), kidney dysfunction [urinary albumin-to-creatinine ratio (UACR)], and metabolic abnormalities [high-density lipoprotein cholesterol, serum uric acid (SUA)]. However, renal (UACR) and metabolic (SUA) biomarkers are likely to be investigated as promising biomarkers for early stage of asymptomatic coronary atherosclerosis, which as expecting could improve diagnostic value of intima-media thickness.