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(Stroke. 2007;38:2074.)
© 2007 American Heart Association, Inc.

Original Contributions

Increased Echolucency of Carotid Plaques in Patients With Type 2 Diabetes

Gerd Östling, MSc; Bo Hedblad, MD, PhD; Göran Berglund, MD, PhD Isabel Gonçalves, MD, PhD

From the Department of Clinical Sciences, Clinical Research Unit Medicine (G.O., G.B.) and Epidemiological Research Group (B.H), and the Department of Cardiology and Internal Medicine, Cardiovascular Research Group, Clinical Research Centre (I.G.), Malmö University Hospital, Malmö, Sweden.

Reprint requests to Gerd Östling, Clinical Research Unit, Entrance 33, 2nd Floor, Malmö University Hospital, 20501 Malmö, Sweden. E-mail gerd.ostling{at}med.lu.se

Background and Purpose— Diabetes is associated with the presence of moderate to large atherosclerotic carotid plaques. Previous carotid ultrasound studies have associated plaques with low echogenicity with a higher risk of cerebrovascular events. The aim of this study was to evaluate whether patients with type 2 diabetes have different plaque echogenicity than do nondiabetic subjects.

Methods— Forty-seven type 2 diabetic and 51 nondiabetic subjects with a carotid plaque in the right artery were included in this study. All patients were born in 1935 to 1936 and were participants in a population-based study. Carotid ultrasonography was performed and the risk factors for cardiovascular disease were determined. Plaque echogenicity was assessed quantitatively on B-mode ultrasound images by standardized gray-scale median values.

Results— Gray-scale median values were significantly lower, indicating more echolucent plaques, in patients with type 2 diabetes compared with nondiabetics (37.0±14.8 vs 45.5±15.4, P=0.007). Of the other risk factors studied, only triglycerides were significantly associated with the echogenicity of the plaque.

Conclusions— Patients with type 2 diabetes have more echolucent plaques compared with nondiabetic subjects. This might be associated with the higher risk of cardiovascular events among diabetics.

Key Words: carotid plaque vulnerability • type 2 diabetes mellitus • ultrasound