Risk factors for arteriosclerosis, such as age, duration of diabetes, sex, and plasma lipoprotein levels, were correlated with the presence of arteriosclerosis obliterans (ASO) as determined by noninvasive methods in 485 of 506 subjects studied with diabetes mellitus.
The diabetic subjects were separated into two major groups for analysis: insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). The NIDDM group was subdivided into those treated by diet (NIDDM-D), sulfonylureas (NIDDM-S), and insulin (NIDDM-I).
Overall, lipoprotein levels in the diabetics were higher than in an age- and sex-adjusted nondiabetic group. Cholesterol levels were elevated in all females and HDL cholesterol levels were depressed in diet- and sulfonylurea-treated females. VLDL levels were most elevated in diet-treated subjects followed by sulfonylurea-treated subjects; VLDL levels in insulin-treated subjects were not elevated.
The prevalence of ASO is related to different factors in each group. In IDDM and NIDDM-I subjects, VLDL triglyceride, LDL cholesterol, and duration of diabetes or age are important risk indicators. By contrast, in NIDDM-S subjects, age alone is the significant risk indicator, and in NIDDM-D subjects, inverse HDL cholesterol correlated with ASO. While males have a higher prevalence of ASO than females, the difference is not statistically significant in any group. Other possible factors, such as hypertension, smoking, and obesity, were not considered in this initial analysis.