Application of multimodal ultrasound in the biomechanical evaluation of carotid intima-media thickness in type 2 diabetes mellitus: a focus on subclinical vascular changes
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective To assess multimodal ultrasound technology in the biomechanical assessment of carotid intima-media thickness (cIMT) in patients with type 2 diabetes mellitus (T2DM), specifically focusing on those with increased cIMT but without atherosclerotic plaques or significant stenosis. Methods In this exploratory cross-sectional study, 65 T2DM patients (thickened vs. normal cIMT) and 27 controls were examined using color Doppler ultrasound flow imaging (CDFI), ultrasound vector flow imaging (V-Flow), and ultra-fast pulse wave velocity (UF-PWV). Measurements included peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), resistance index (RI), wall shear stress (WSS), pulse wave velocity at the beginning of systole (PWV-BS), and pulse wave velocity at the end of systole (PWV-ES). Differences across groups and independent factors associated with cIMT were analyzed via correlation and multivariable linear regression. Results The T2DM group exhibited higher HbA1c levels than the control group ( P < 0.001). The T2DM with thickened cIMT group exhibited significantly lower EDV ( P = 0.005) and higher Body Mass Index (BMI) ( P = 0.006) than the control group. Furthermore, the same group showed significantly lower mean WSS (WSSmean) than the control and T2DM with normal cIMT groups ( P < 0.05). The T2DM with thickened and normal cIMT groups showed significantly higher PWV-ES than the control group ( P < 0.05). A positive correlation was observed between cIMT and BMI ( ρ = 0.392, P < 0.001), HbA1c ( ρ = 0.425, P < 0.001), and PWV-ES ( ρ = 0.506, P < 0.001). Both WSSmean ( ρ = −0.365, P < 0.001) and EDV ( ρ = −0.209, P < 0.05) were negatively correlated with cIMT. After adjustment for clinical covariates, BMI, WSSmean, and PWV-ES were identified as independent factors associated with cIMT in the overall cohort. In the T2DM group, PWV-ES ( B = 0.034, P = 0.004) and WSSmean ( B = −0.060, P = 0.039) remained independently associated with cIMT. Conclusion Preliminary findings suggest V-Flow and UF-PWV imaging may detect biomechanical alterations in T2DM patients. While these techniques may offer insights into subclinical vascular remodeling prior to plaque formation, this cross-sectional study should be cautiously interpreted as hypothesis-generating.
Source: Frontiers in Endocrinology
Authors: Xuhong Nan, Linmei Tang, Xue Fang, Xinlei Yang, Yu Kang
Institution: Chengdu University of Traditional Chinese Medicine
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7154500358