Abstract:
Background. Atherosclerosis is a progressive systemic disease associated with fatal
cardiovascular (CV) complications. Diabetes mellitus (DM) and smoking are two major CV
risk factors contributing to the onset of atherosclerotic disease. This study aims to identify
which vascular territories are affected earlier.
Objective(s). To compare the degree of carotid versus peripheral vascular damage in
patients with DM and smoking history, in order to determine which vascular region is
affected first.
Materials and methods. The study included: Group I with DM (n=30) and Group II -
smokers (n=30), aged 45-65 years (60% men, 40% women). The mean duration of DM was
9.4. The smoking index was 18. Diagnostic methods: Doppler ultrasound of the carotid,
femoral and tibial arteries, assessment of intima-media thickness (IMT), degree of stenosis
and presence of calcifications.
Results. In Group I, vascular lesions were predominantly found in the lower limb arteries:
23% had intima-media thickness > 1.0 mm without stenosis, 40% had moderate stenosis
(50-69%) and 37% had significant stenosis (>70%), with calcifications observed in 57% of
patients. Significant carotid stenoses were detected in only 23% of the diabetes mellitus
group. In Group II, carotid arteries were more frequently affected: 17% had intima-media
thickness > 1.0 mm, 60% had moderate stenosis and 23% had significant stenosis, with
calcifications present in 42% of cases. Significant lower limb stenoses were observed in 28%
of smokers.
Conclusion(s). In patients with diabetes mellitus, lower limb arteries tend to be affected
earlier and more severely, whereas in smokers, the carotid arteries are more commonly
involved. These distinctions may inform screening strategies and optimize the management
of cardiovascular complications.
