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.