The Relationship between The Carotid Intima-Media Thickness, Coronary Risk Factors, C-Reactive Protein and Peripheral Circulation among Elderly Diabetic Patients

Abstract

Diabetes mellitus is a syndrome causing long-standing metabolic derangement which is associated with functional and structural changes in many organs, particularly the vascular system.Persons with DM are at an increased risk for atherosclerosis which is responsible for CVD. Some of this excess risk relates tonontraditional risk factors (e.g., elevated levels of CRP). Recent advances in basic science have established a fundamental role for inflammation in atherosclerosis and CVD. It is speculated that low grade inflammation within the arteries can raise CRP levels and also CRP may have a direct role in the pathogenesis of atherosclerosis and vascular inflammation.Diabetic patients have elevated CRP levels, which may suggest a role for inflammatory processes in the pathogenesis of diabetes, also elevated baseline CRP predict occurrence of future DM. Peripheral arterial disease leads to substantial morbidity andmortality. The majority of patients with PAD also have concomitant CAD with subsequentischemic stroke or cardiovascular death.It has many risk factors include advanced age, hypertension,hyperlipidemia, DM, cigarette smoking and presence of several inflammatory biomarkers, such as CRP. The most efficient, objective and practical means of documenting presence and severity of PAD is measurement of ABI. Carotid artery intima-media thickness is a marker of atherosclerosis in coronary or lower limb arteries. It has been demonstrated to be higher in people with DM and macrovascular disease. There is a close relationship betweenCIMT and a number of cardiovascular risk factors.Also it associated with the prevalence of PAD and with higher level of CRP. The objectives of this work are to assess the correlation between the CIMT, coronary risk factors (such as age, male sex, smoking, high blood pressure and elevated blood cholesterol levels), the inflammatory mediator CRP and PAD among elderly diabetic patients.