Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Aug 15, 2025; 16(8): 104180
Published online Aug 15, 2025. doi: 10.4239/wjd.v16.i8.104180
Comprehensive analysis of risk factors associated with carotid plaque in patients with type 2 diabetes mellitus
Lei Shi, Neng-Juan Li
Lei Shi, Department of Endocrinology, Zhejiang Hospital, Hangzhou 310030, Zhejiang Province, China
Neng-Juan Li, Department of Endocrinology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Author contributions: Shi L spearheaded the conceptualization, data curation, formal analysis, methodology, resource gathering, software management, and drafting of the original manuscript; Li NJ contributed to the methodology and played a significant role in reviewing and editing the manuscript; and this collaborative effort ensured a comprehensive approach to the study's execution and documentation.
Supported by the Zhejiang Traditional Chinese Medicine Science and Technology Plan Project, No. 2021ZB133 and No. 2017ZB049.
Institutional review board statement: This study was approved by the Ethic committee of The Second Affiliated Hospital of Zhejiang Chinese Medical University on August 14, 2024.
Informed consent statement: Written informed consent for publication was obtained from all patients and/or their families included in this retrospective analysis.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data sets generated and analyzed during this study are not public, but under reasonable requirements at nengjuanli1010@yeah.net, the correspondence author can provide.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Neng-Juan Li, MD, Department of Endocrinology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, No. 318 Chaowang Road, Gongshu District, Hangzhou 310053, Zhejiang Province, China. nengjuanli1010@yeah.net
Received: December 13, 2024
Revised: April 7, 2025
Accepted: July 2, 2025
Published online: August 15, 2025
Processing time: 244 Days and 19 Hours
Abstract
BACKGROUND

Carotid atherosclerosis is a common complication in patients with type 2 diabetes mellitus (T2DM) and is closely associated with an increased risk of cardiovascular events.

AIM

To identify the key demographic, clinical, and biochemical factors associated with carotid plaque formation in T2DM patients and evaluate their predictive value.

METHODS

This retrospective study included 266 T2DM patients (control group, n = 158; observation group, n = 108) recruited between January 2021 and July 2024. Participants underwent carotid ultrasonography to measure intima-media thickness (IMT) and detect carotid plaques. Comprehensive demographic and biochemical data, including age, body mass index (BMI), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), serum creatinine (Scr), urinary albumin-to-creatinine ratio (UACR), and serum uric acid (SUA), were collected. Statistical analyses, including Pearson correlation, logistic regression, and receiver operating characteristic (ROC) curve analysis, were performed to identify and evaluate factors associated with carotid plaque formation.

RESULTS

Significant differences in age, BMI, HbA1c, FPG, Scr, UACR, and SUA were observed between groups (all P < 0.05). Pearson correlation analysis showed IMT was positively associated with age, FPG, HbA1c, Scr, UACR, and SUA, and negatively with HDL-C. Multivariate logistic regression identified age (OR = 1.050, 95%CI: 1.015-1.087), FPG (OR = 1.096, 95%CI: 1.006-1.192), HbA1c (OR = 1.234, 95%CI: 1.057-1.445), SBP (OR = 1.018, 95%CI: 1.002-1.034), Scr (OR = 1.029, 95%CI: 1.011-1.046), UACR (OR = 1.024, 95%CI: 1.010-1.037), SUA (OR = 1.006, 95%CI: 1.003-1.009), and HDL-C (OR = 0.329, 95%CI: 0.119-0.917) as independent predictors of IMT (all P < 0.05). ROC analysis showed UACR (AUC = 0.718) and SUA (AUC = 0.651) had predictive value for carotid plaque.

CONCLUSION

This study highlights the multifactorial nature of carotid atherosclerosis in T2DM, with age, BMI, poor glycemic control, renal dysfunction, and metabolic disturbances identified as key risk factors. The findings underscore the importance of comprehensive risk assessment and targeted interventions to prevent vascular complications in this high-risk population.

Keywords: Type 2 diabetes mellitus; Carotid plaque; Intima-media thickness; Serum uric acid; Urinary albumin-to-creatinine ratio; Risk factors

Core Tip: This study aims to shed light on the key risk factors contributing to carotid plaque formation in patients with type 2 diabetes mellitus (T2DM), a condition that significantly increases the risk of cardiovascular events. Our findings indicate that a range of demographic, clinical, and biochemical factors, including age, glycemic control, renal dysfunction, and metabolic disturbances, play a crucial role in the development of carotid atherosclerosis. Through a comprehensive analysis involving carotid ultrasonography, logistic regression, and receiver operating characteristic curve analysis, we identify important predictors of carotid plaque formation and provide valuable insights for improving cardiovascular risk assessment in T2DM patients.