Metabolic Predictors of Subclinical Cardiovascular Risk in Newly Diagnosed Type 2 Diabetes

Abstract

Newly diagnosed type 2 diabetes mellitus (T2DM) is associated with an increased burden of cardiovascular risk, even before clinically apparent cardiovascular disease develops. This study evaluated metabolic predictors of subclinical cardiovascular abnormalities in adults recently diagnosed with T2DM. A prospective observational study was conducted among 164 adults diagnosed with T2DM within the previous 12 months and without a documented history of cardiovascular disease. Anthropometric measurements, blood pressure, glycemic indices, lipid parameters, fasting insulin, uric acid, high-sensitivity C-reactive protein, and urinary albumin-to-creatinine ratio were assessed at enrollment. Subclinical cardiovascular status was evaluated using carotid intima-media thickness (CIMT), carotid-femoral pulse wave velocity (cfPWV), and brachial artery flow-mediated dilation (FMD). Participants with increased CIMT or elevated cfPWV demonstrated higher waist-to-height ratio, triglyceride-to-HDL cholesterol ratio, fasting insulin, uric acid, and hs-CRP concentrations than participants without vascular abnormalities. CIMT showed significant positive correlations with age, systolic blood pressure, HbA1c, waist-to-height ratio, and triglyceride-to-HDL ratio. In multivariable analysis, waist-to-height ratio, systolic blood pressure, triglyceride-to-HDL ratio, and uric acid were independently associated with increased CIMT, whereas fasting insulin and hs-CRP were independently associated with impaired FMD. Participants with three or more adverse metabolic indicators had a significantly greater prevalence of subclinical vascular abnormalities than those with fewer indicators. These findings suggest that central adiposity, atherogenic lipid patterns, insulin resistance, and low-grade inflammation may contribute to early cardiovascular abnormalities in newly diagnosed T2DM. Early assessment of these metabolic characteristics may improve identification of individuals requiring intensified cardiovascular risk reduction.