Association between carotid ultrasonographic parameters and microvascular and macrovascular complications in diabetes: A systematic review and meta-analysis

Meimei Liao; Sen Chen; Ruiqiang Guo

doi:10.1016/j.jdiacomp.2023.108554

Association between carotid ultrasonographic parameters and microvascular and macrovascular complications in diabetes: A systematic review and meta-analysis

J Diabetes Complications. 2023 Aug;37(8):108554. doi: 10.1016/j.jdiacomp.2023.108554. Epub 2023 Jun 28.

Authors

Meimei Liao¹, Sen Chen², Ruiqiang Guo³

Affiliations

¹ Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan 430060, PR China.
² Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, PR China.
³ Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan 430060, PR China. Electronic address: ruiqiangguo@outlook.com.

PMID: 37418962
DOI: 10.1016/j.jdiacomp.2023.108554

Abstract

Objective: The present meta-analysis aimed to assess the association between carotid ultrasonographic parameters and diabetic microvascular and macrovascular complications.

Methods: All published articles were searched in electronic databases including PubMed, Embase, Cochrane Library, and Web of Science databases from the inception to May 27, 2023. Common carotid artery intima-media thickness (CCA-IMT), carotid bifurcation intima-media thickness (CB-IMT), internal carotid artery intima-media thickness (ICA-IMT), carotid plaque, carotid plaque score, plaque number, plaque thickness, carotid atherosclerosis, and resistivity indices (RIs) of ultrasonographic parameters were assessed. The odds ratio (OR), weighted mean difference (WMD), with the 95 % confidence interval (CI) were pooled to estimate the effect. Subgroup analyses were performed in terms of the type of diabetes and study design. Sensitivity analysis was used to evaluate the robustness of the results.

Results: A total of 25 studies involving 12,102 diabetic patients were included in this systematic review and meta-analysis. Our findings suggested the associations between increased CCA-IMT and the risk of diabetic microvascular (WMD: 0.059, 95%CI: 0.026 to 0.091, P < 0.001) and macrovascular complications (WMD: 0.124, 95%CI: 0.061 to 0.187, P < 0.001) including cardiovascular events (OR: 2.362, 95%CI: 1.913 to 2.916, P < 0.001). Subgroup analyses also elaborated an association between CCA-IMT and diabetic microvascular and macrovascular complications. The results of sensitivity analysis show that the association is relatively stable.

Conclusion: Our findings revealed associations between carotid ultrasonographic parameters and microvascular and macrovascular complications of diabetes. Application of the carotid ultrasonographic parameters could be a non-invasive method for the early detection of long-term complications of diabetes.

Keywords: Carotid ultrasonographic parameters; Diabetes; Macrovascular; Microvascular; meta-analysis.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Carotid Arteries / diagnostic imaging
Carotid Artery Diseases* / complications
Carotid Artery Diseases* / diagnostic imaging
Carotid Artery Diseases* / epidemiology
Carotid Artery, Common / diagnostic imaging
Carotid Intima-Media Thickness
Diabetes Complications* / complications
Diabetes Mellitus*
Humans
Risk Factors