A Study of Association between Fasting and Postprandial Triglyceride Levels and Carotid Intima-Media Thickness in Type 2 Diabetes Patients

BACKGROUND: Ischemic heart disease is the major cause of mortality and morbidity in individuals with diabetes. More than 80% of the deaths in adults with diabetes mellitus is accounted by the macro vascular complications like - IHD, peripheral arterial disease and CVA Diabetic dyslipidemia plays main role in the pathogenesis of accelerated atherosclerosis. It consists of Inceased triglycerides, Decreased HDL and Elevated small dense LDL (sLDL). In the most recent times, triglyceride levels have emerged as an important independent risk factor for atherosclerosis. Diabetes mellitus was predominantly a post prandial metabolic disorder. Serum triglycerides usually increase maximally 3-6 hours after a meal, once postprandial triglyceridemia occurs, it is further increased by the next meal. As we stay in a post prandial state for most of the day, evaluationt of serum triglycerides in both fasting and postprandial state may provide a more reliable information of hypertriglyceridemia among diabetic patients. To evaluate the role of fasting and post prandial hypertriglyceridemia carotid intima media thickness (CIMT) is used as it is a surrogate marker of atherosclerosis OBJECTIVES: To evaluate the extent of association between fasting and postprandial triglyceride levels and carotid artery intima media thickness in patients with type 2 diabetes mellitus. MATERIAL & METHODS: This is a comparative study in which 100 type 2 DM patients in the age group Of 40-65 years, with average duration between 1-5 years, of diabetics are included in the study STANDARDIZED MIXED MEAL TEST: Subjects under study are given a standardized mixed meal test after an overnight fast. The total energy content of the standardized mixed meal was 9Kcal/kg, with 20% from fat, 60% of energy from carbohydrate, 20% of energy from protein. Blood samples for measuring lipid profile were taken before and 4hrs after the standardized meal. MEASUREMENT OF CAROTID IMT: Carotid intima media thicknening is measured by: Carotid artery Doppler by B-mode ultrasound using a 7.5 MHZ transducer. CONCLUSION: The conclusion of the present study is that there is a correlation between postprandial hypertriglyceridemia and carotid intima- media thickness (CIMT