Published: 2017-03-23

Lipid profile and carotid artery intima-media thickness in diabetic and non-diabetic ischaemic stroke

Preetha R. Pillai, Dharmendra Tiwari, O. P. Jatav, Hindeshwari Rai


Background: Stroke is one of the leading reasons for mortality throughout the world. Measurement of carotid intima media thickness (CIMT) is a reliable marker for the development of atherosclerosis and ischemic stroke (IS). The aim was to study and correlate lipid profile and CIMT in diabetic and non-diabetic IS patients.

Methods: An observational study was done including 120 IS patients divided into two groups- diabetes (n=60, diabetic stroke patients) and non-diabetes (n=60, non-diabetic stroke patients) having age >18 years, admitted in Medicine and Neurology wards of G. R. Medical College, Gwalior, Madhya Pradesh, India between August 2015 to August 2016. Detailed history along with investigations such as fasting blood sugar (FBS), post prandial blood sugar (PPBS) and fasting lipid profile including triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL) and total cholesterol (TC) was done. The common and the internal carotid arteries of both sides were evaluated ultrasonographically using a high frequency linear probe. All the data were analysed using IBM SPSS- ver.20 software. Data was expressed as percentage. Analysis was performed using two-way ANOVA and independent sample student t test. Pearson correlation was used to establish the relation between the data. P values <0.05 was considered to be significant.

Results: Most common age group among diabetes and non-diabetes IS patients were 51-60 years (26.66%) and 61-70 years (28.33%) respectively with male predominance (75% and 66.67% respectively). Most of the diabetic IS patients had FBS >200 mg/dl (41.66%) and PPBS >250 mg/dl, (50%). Out of 120 IS patients, 55 (45.83%) had CIMT ≤0.8 mm and 65 (54.16%) patients had CIMT >0.8 mm. Lipid parameters including TC (p=0.034), TG (p=0.022), HDL (p=0.039), VLDL (p=0.043) and LDL (p=0.017) were significantly different between groups (p<0.05). Mean CIMT in patients with diabetes and non-diabetes was 1.03±0.255 mm and 0.83±0.54 mm respectively (p=0.006). A significant positive correlation was recorded between CIMT and TC (r=0.36, p=0.006), TG (r=0.48, p=0.0001) and VLDL (r=0.46, p=0.0001) among diabetes stroke patients. Among non-diabetes stroke patients, TC (r=-0.25, p=0.042), TG (r=-0.44, p=0.0003), HDL (r=-0.33, p=0.016) and LDL (r=-0.58, p=<0.001) were negatively correlated and VLDL (r=0.92, p=<0.0001) was positively correlated with CIMT.

Conclusions: Lipid parameters including TC, TG, LDL and VLDL were significantly raised in diabetic stroke patients and had a positive correlation with the risk of stroke.  CIMT was significantly high in diabetic stroke patients. Correlation of lipid parameters (TC, TG and VLDL) with CIMT in diabetic stroke patients were significantly positively correlated, in non-diabetic ischemic stroke patients’ lipid parameters (TC, TG, HDL and LDL) were negatively correlated.


Diabetes mellitus, Dyslipidemia, Ischaemic stroke, Lipid parameters, Stroke risk

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Kochupillai N. Clinical endocrinology in India. Curr Sci. 2000;79:1061-7.

McGarry PA, McMohan CA, Montenegro MR. General findings of the International atherosclerosis project. Lab Invest. 1968;18:498-502.

Frouse JR. An evaluation of methods for imaging and quantifying coronary and carotid lumen stenosis and atherosclerosis. Circulation. 1993;87(II):1117-33.

Smith SC, Greenland P, Grundy SM. AHA Conference proceedings prevention conference v beyond secondary / prevention: identifying the high-risk patient for primary prevention. Executive summary. Circulation. 2000;101:111-6.

Greenland P, Abrams J, Aurigemma FP, Bond MG, Clark LT, Criqui MH, et al. Prevention Conference V: Beyond secondary prevention identifying the high-risk patient for primary prevention: non-invasive tests of atherosclerotic burden; Writing Group III. Circulation. 2000;101:E16-22.

Gayathri R, Chandni R, Udayabhaskaran V. Carotid artery intima media thickness in relation with atherosclerotic risk factors in patients with type 2 diabetes mellitus. JAPI. 2012;60:20-4.

Arabadzhieva D, Georgieva Z, Kaprelyan A, Tsukeva A, Radeva N. Lipid profile in ischemic stroke patients. Sci Techn. 2014;4(1):31-4.

Nirmala AC, Mamatha TN, Priya Shree R, Avinash BH. Study of lipid profile in non-diabetic stroke in young. Sch J App Med Sci. 2015;3(3C):1259-65.

Das SK, Sarkar A, Pramanik S, Bandyopadhyay M, Mondal K, Singh SK. Carotid artery intima-media thickness in patients with acute ischemic stroke and its correlation with risk factors for atherosclerosis and/or stroke. Asian J Med Sci. 2015;6(1):22-7.

Bettegowda S, Iyengar VS, Pillappa SK. Carotid intima media thickness in diabetic and non diabetic subjects: a study from rural hospital. Sch J App Med Sci. 2015;3(7A):2485-92.

Rajeev H, Krishnappa, Savitha V. Study of carotid intima media thickness in patients with acute ischemic stroke and its correlation with risk factors of ischemic stroke- a case control study. J Evol Med Dent Sci. 2013;2(44):8444-54.

Touboul PJ, Elbaz A, Koller C. Common carotid artery intima media thickness and brain infarction: the Etude du Profil Genetique de l’Infarctus Cerebral (GENIC) case-control study: the GENIC Investigators. Circulation. 2000;102:313-8.

Sau TJ, Dey SK, Chatterjee A, Kumar A, Biswas UK. Common carotid artery intima-media thickness reflects the cumulative burden of atherosclerosis and predicted well by total cholesterol/HDL-C ratio in Type II diabetic patients- a case controlled study based from Kolkata, India. Asian J Med Sci. 2014;5(1):9-14.

Mohan V, Ravikumar R, Shanthi Rani S, Deepa R. Intimal media thickness of the carotid artery in South Indian diabetic and nondiabetic subjects: the Chennai Urban Population Study (CUPS). Diabetologia. 2000;43(4):494-9.

Lorenz MW, von Kegler S, Steinmetz H, Marcus HS, Sitzer M. Carotid Intima-media thickening indicates a higher vascular risk across a wide age range: prospective data from the Carotid Atherosclerosis Progression Study (CAPS). Stroke. 2006;37:87-92.