Clinical and dietary predictors of common carotid artery intima media thickness in a population with type 1 and type 2 diabetes: A cross-sectional study

Table 1 Cohort characteristics

Characteristic	Whole cohort (n = 150)	Type 1 diabetes (n = 23)	Type 2 diabetes (n = 127)	P value1
Age (yr)	56 ± 14	36 ± 14	60 ± 11	0.0001
Weight (kg)	96.9 ± 21.4	85.6 ± 25.2	98.9 ± 20.0	0.006
Height (m)	1.7 ± 0.1	1.71 ± 0.1	1.71 ± 0.1	0.90
BMI (kg/m2)	33.1 ± 7.0	29.4 ± 9.3	33.8 ± 6.3	0.005
Sex, male n (%)	86 (57)	9 (39)	77 (61)	0.06
Diagnosed with diabetes (yr)	9.7 ± 9.3	19.1 ± 14.2	8.1 ± 6.9	0.001
Smoking status n (%)				0.25
Never smoked	74 (49)	15 (65)	59 (47)
Past smoker	68 (46)	7 (31)	61 (48)
Current smoker	8 (5)	1 (4)	7 (5)
Smoking pack years2 (yr)	9.6 ± 15.6	1.7 ± 4.4	11.0 ± 16.5	0.008
Systolic blood pressure (mmHg)	127 ± 14	124 ± 14	128 ± 14	0.15
Diastolic blood pressure (mmHg)	72 ± 10	69 ± 9	72 ± 10	0.18
Mean arterial pressure (mmHg)	90 ± 10	87 ± 8	91 ± 10	0.10
Heart rate (bpm)	74 ± 13	77 ± 10	73 ± 13	0.21
Pulse pressure (mmHg)	56 ± 13	54 ± 15	56 ± 13	0.60
Mean CCA IMT (mm)	0.71 ± 0.13	0.58 ± 0.12	0.73 ± 0.11	< 0.001
Mean maximum CCA IMT (mm)	0.79 ± 0.14	0.66 ± 0.13	0.81 ± 0.12	< 0.001
Prescribed anti-hypertensive medication n (%)	85 (57)	7 (30)	78 (61)	0.006
Prescribed lipid lowering medication n (%)	82 (55)	4 (17)	78 (61)	< 0.001
Diabetes treatment n (%)				< 0.001
None	30 (20.0)	0 (0)	30 (24)
OHA	65 (43.3)	0 (0)	65 (51)
Insulin	26 (17.3)	23 (100)	3 (2)
OHA + insulin	29 (19.3)	0 (0)	29 (23)
Total cholesterol (mmol/L)	4.1 ± 1.0	4.1 ± 1.0	4.1 ± 1.0	0.99
HDL cholesterol (mmol/L)	1.2 ± 0.4	1.5 ± 0.3	1.1 ± 0.3	< 0.001
LDL cholesterol (mmol/L)	2.4 ± 0.9	2.4 ± 0.9	2.4 ± 0.9	0.97
Triglycerides (mmol/L)	1.3 ± 1.2	0.6 ± 0.4	1.4 ± 1.2	0.003
Glucose (mmol/L)	8.1 ± 3.0	10.1 ± 4.0	7.7 ± 2.6	< 0.001
HbA1c (%) (mmol/mol)	7.3 ± 1.4 (57 ± 16)	7.6 ± 1.1 (60 ± 12)	7.3 ± 1.5 (56 ± 16)	0.27
CRP (mg/L)	2.5 ± 2.2	1.6 ± 1.9	2.6 ± 2.3	0.15
Presence of Microalbuminuria n (%)3
Yes	23 (15)	3 (13)	20 (16)	0.74
No	127 (85)	20 (87)	107 (84)
Spot urine Na:K	1.3 ± 0.9	1.4 ± 0.9	1.3 ± 0.9	0.62

¹Type 1 diabetes vs type 2 diabetes;

²Number packs (25 cigarettes)/day × number years smoked;

³Albumin:creatinine > 2.5 for men and > 3.5 for women[18]. OHA: Oral hypoglycaemic agents; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CRP: C reactive protein; HbA1c: Haemoglobin A1c; CCA IMT: Common carotid artery intima media thickness.

Table 2 Predictors of mean and mean maximum common carotid artery intima media thickness in univariate analysis and stepwise linear regression

Predictor	Mean CCA IMT	Mean maximum CCA IMT	Mean CCA IMT			Mean maximum CCA IMT
	r	r	β	t	P	β	t	P
Age	0.661	0.651	0.006	10.8	0.0001	0.006	10.5	0.001
Sex	-0.13	-0.143	-			-
Type of diabetes	0.431	0.411	-			-
Years since diabetes diagnosis	0.08	0.09	-			-
Smoking pack years	0.192	0.192	-			-
Weight	0.163	0.163	0.001	2.4	0.017	0.001	2.3	0.02
BMI	0.182	0.182	-			-
Systolic blood pressure	0.261	0.271	-			-
Diastolic blood pressure	-0.01	-0.006	-			-
Heart rate	-0.241	-0.231	-			-
Pulse pressure	0.291	0.291	-			-
Anti-hypertension medication prescription	-0.341	-0.321	-			-
Lipid lowering medication prescription	-0.301	-0.301	-			-
Total cholesterol	-0.001	-0.001	-			-
LDL cholesterol	-0.007	-0.02	-			-
HDL cholesterol	-0.182	-0.172	-			-
Triglycerides	0.13	0.143	-			-
Fasting glucose	0.03	0.03	-			-
HbA1c	-0.04	-0.04	-			-
Microalbuminuria	0.153	0.153	-			-
Summarised r2 model			0.46			0.44

¹P < 0.01;

²P < 0.05;

³P < 0.1. HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CRP: C reactive protein; HbA1c: Haemoglobin A1c; CCA IMT: Common carotid artery intima media thickness; BMI: Body mass index.

Table 3 Nutrient intake as reported in the food frequency questionnaire and the correlation with common carotid artery intima media thickness

Nutrient intake	Median (IQR)	Mean CCA IMT		Mean maximum CCA IMT
		Univariate	Adjusted3	Univariate	Adjusted3
		r	r	r	r
Energy (kcal)	1652 (1343, 2165)	-0.162	-0.042	-0.152	-0.052
Protein (g/d)	88 (66,112)	-0.181	-0.022	-0.171	-0.022
% E protein	21 (18, 23)	0.022	0.102	0.032	0.112
Total fat (g/d)	66 (52, 92)	-0.181	-0.072	-0.181	-0.082
% E total fat	37 (33, 40)	-0.142	-0.132	-0.162	-0.152
Saturated fat (g/d)	25 (19, 35)	-0.161	-0.072	-0.171	-0.092
% E saturated fat	14 (12, 16)	-0.152	-0.142	-0.161	-0.162
Monounsaturated fat (g/d)	24 (18, 33)	-0.181	-0.072	-0.181	-0.082
% E monounsaturated fat	13 (12, 15)	0.192	-0.092	-0.132	-0.112
Polyunsaturated fat (g/d)	11 (8, 14)	-0.142	-0.062	-0.132	-0.052
% E polyunsaturated fat	6 (5, 7)	0.032	-0.022	0.032	-0.022
Carbohydrate (g/d)	160 (134, 216)	-0.132	-0.062	-0.132	-0.062
% E carbohydrate	40 (36, 44)	0.042	-0.062	0.042	-0.062
Sugar (g/d)	74 (56, 94)	-0.012	0.032	-0.012	-0.032
Fibre (g/d)	20 (16, 26)	-0.122	-0.042	-0.122	-0.052
Sodium (mg/d)	2177 (1696, 2957)	-0.162	-0.062	-0.152	-0.062
Potassium (mg/d)	2771 (2128, 3403)	-0.072	0.032	-0.062	0.042
Alcohol (g/d)	2 (0, 8)	0.062	0.112	0.072	0.112

¹P < 0.05;

²P > 0.05;

³Adjusted for age, sex and weight. CCA IMT: Common carotid artery intima media thickness.

Table 4 Dietary intake by food group as reported in the food frequency questionnaire and the correlations with common carotid artery intima media thickness

Dietary intake	g/d median (IQR)	Mean CCA IMT		Mean maximum CCA IMT
		Univariate	Adjusted4	Univariate	Adjusted4
		r	r	r	r
Total breads and cereals	204 (141, 320)	-0.202	-0.073	-0.182	-0.053
Breakfast cereal	18 (3, 45)	-0.182	-0.183	-0.192	-0.203
Bread	60 (30, 90)	0.063	-0.083	0.063	-0.073
Pasta/rice	59 (32, 109)	-0.281	0.013	-0.271	0.013
Total vegetables/legumes	151 (112, 217)	0.063	0.103	0.063	0.093
Vegetables	140 (103, 206)	0.063	0.113	0.063	0.103
Legumes	7 (3, 13)	-0.023	-0.073	-0.023	-0.063
Total fruit	239 (120, 340)	0.133	0.113	0.133	0.103
Fresh/canned fruit	187 (99, 282)	0.192	0.163	0.182	0.153
Juice	6 (0, 41)	-0.083	-0.073	-0.093	-0.073
Total dairy	381 (232, 501)	0.033	0.063	0.043	0.073
Reduced fat dairy	277 (44, 446)	0.083	0.083	0.103	0.113
Full fat dairy	9 (2, 22)	-0.063	-0.033	-0.073	-0.053
Total meats and alternatives	169 (105, 217)	-0.153	-0.013	-0.153	-0.013
Red meat	56 (31, 106)	-0.212	-0.043	-0.202	-0.043
Processed meat	19 (8, 32)	0.013	0.023	0.013	0.013
Chicken	34 (19, 51)	-0.163	0.033	-0.153	0.043
Fish	29 (15, 49)	-0.013	0.043	0.013	0.043
Tofu	0 (0, 1)	-0.103	-0.063	-0.093	-0.043
Nuts	4 (1, 10)	-0.172	-0.013	-0.172	-0.023
Eggs	13 (10, 34)	0.073	-0.043	0.063	-0.053
Total extra foods5	126 (66, 236)	0.033	0.073	0.043	0.083

¹P < 0.01;

²P < 0.05;

³P > 0.05;

⁴Adjusted for age, sex and weight;

⁵Takeaways, sweets, savoury snacks and alcoholic beverages. CCA IMT: Common carotid artery intima media thickness.