Yoshida M, Takamatsu J, Yoshida S, Tanaka K, Takeda K, Higashi H, Kitaoka H, Ohsawa N
Aino Hospital, Ibaraki-City, Osaka, Japan.
Horm Metab Res. 1999 Oct;31(10):558-63. doi: 10.1055/s-2007-978795.
This study was aimed at investigating the degree of calcification of coronary arteries in type II diabetes mellitus for the purpose of examining as risk factors for coronary disease as well as parameters of diabetic complications. One hundred and three patients with type II diabetes were studied by the newly developed noninvasive technology of electron beam computed tomography, in which the degree of calcification was expressed as coronary calcification scores. The mean +/- SE value of coronary calcification scores were 247.5 +/- 48.1, which were significantly greater than the control patients without diabetes (148.9 +/- 48.3, p<0.05). In the diabetics, the coronary calcification scores had a significant (p < 0.01) correlation with patient age and duration of diabetes. The scores also had a significant (p<0.05) difference between patients who did and did not smoke cigarettes, and between patients with and without hypertension. The scores were significantly (p < 0.01) different between patients with and without hypertension. The scores were significantly (p < 0.01) different between presence and absence of diabetes-specific complications including retinopathy, neuropathy, and nephropathy. In a subgroup of patients without any signs of coronary disease, the scores showed a significant (p<0.01) difference between presence and absence of diabetes-specific complications, but no significant difference with smoking or hypertension. These data suggest that the extent of coronary calcifications and the development of ischemic heart disease seem to be closely related to the association of diabetic complications. Use of electron beam computed tomography seems to be useful in obtaining the information to predict future development of diabetic-specific complications.
本研究旨在调查II型糖尿病患者冠状动脉钙化程度,以检验其作为冠心病危险因素以及糖尿病并发症参数的情况。采用新开发的电子束计算机断层扫描无创技术对103例II型糖尿病患者进行了研究,其中钙化程度以冠状动脉钙化评分表示。冠状动脉钙化评分的平均±标准误值为247.5±48.1,显著高于无糖尿病的对照患者(148.9±48.3,p<0.05)。在糖尿病患者中,冠状动脉钙化评分与患者年龄和糖尿病病程显著相关(p<0.01)。吸烟和不吸烟患者之间、有高血压和无高血压患者之间的评分也存在显著差异(p<0.05)。有高血压和无高血压患者之间的评分差异显著(p<0.01)。有糖尿病特异性并发症(包括视网膜病变、神经病变和肾病)和无并发症患者之间的评分差异显著(p<0.01)。在无任何冠心病迹象的患者亚组中,评分在有和无糖尿病特异性并发症之间存在显著差异(p<0.01),但与吸烟或高血压无显著差异。这些数据表明,冠状动脉钙化程度和缺血性心脏病的发生似乎与糖尿病并发症的关联密切相关。电子束计算机断层扫描的应用似乎有助于获取预测糖尿病特异性并发症未来发展的信息。