Frost D, Fröhlich B, Beischer W
Bürgerhospital Stuttgart, Zentrum für Innere Medizin-Medizinische Klinik 3.
Dtsch Med Wochenschr. 2000 May 26;125(21):648-54. doi: 10.1055/s-2007-1024414.
Type 2 diabetes mellitus is an important risk factor for the development of atherosclerosis. Early subclinical manifestation of atherosclerosis can be reliably recognized by measuring the thickness of the intima and media (IMT). The aim of this study was to examine vessel changes and the extent of possible risk factors in patients with newly diagnosed type 2 diabetes (interval since diagnosis < or = 1 year) and control persons without DM.
Maximal IMT was measured by high resolution ultrasound of the common carotid (CCA) and femoral arteries (FA) in 51 type 2 diabetics and 18 controls. Various clinical and laboratory data (urinary excretion of albumin and protein, blood lipids) as well as amount of smoking, frequency of eating fruit and amount of sport activity were obtained in a standardized manner.
The patients' body-weight was markedly greater and blood pressure significantly higher than that of the controls. Hypertension was present in 43% of patients (control group 11%) microalbuminuria in 26%. Mean IMT of the CCA was 0.76 +/- 0.20 mm in the patients and 0.64 +/- 0.16 mm in the controls (p < 0.01). The IMT of the FA, however, was not significantly different in the two groups (patients: 0.80 + 0.30 mm, controls: 0.75 +/- 0.31 mm). The IMT of the CCA was correlated with the patients' age (r = 0.55; p < 0.001), with the level of total cholesterol (r = 0.39; p < 0.01), and with the presence of hypertension (r = 0.38; p < 0.01). Patients who daily eat fruit had a significantly lower IMT of the FA than those who did not eat fruit regularly (no such difference was found regarding the CCA). Linear multiple regression analysis indicated that these variables were factors that independently affected the IMD of the CAA and the FA.
An increase in subclinical atherosclerosis was demonstrated in type 2 diabetics already during the first year after diagnosis. The risk factors for the development of atherosclerosis in newly diagnosed diabetics exert a greater effect on the CCA than the FA. Regular eating of fruit seems to have a favourable effect on the progression of atherosclerosis of the FA.
2型糖尿病是动脉粥样硬化发生的重要危险因素。通过测量内膜和中膜厚度（IMT）能够可靠地识别动脉粥样硬化的早期亚临床症状。本研究旨在检查新诊断的2型糖尿病患者（诊断后间隔时间≤1年）和无糖尿病的对照者的血管变化以及可能的危险因素程度。
对51例2型糖尿病患者和18例对照者进行颈总动脉（CCA）和股动脉（FA）的高分辨率超声检查以测量最大IMT。以标准化方式获取各种临床和实验室数据（白蛋白和蛋白质的尿排泄、血脂）以及吸烟量、吃水果的频率和体育活动量。
患者的体重明显高于对照者，血压也显著更高。43%的患者患有高血压（对照组为11%），26%的患者有微量白蛋白尿。患者的CCA平均IMT为0.76±0.20mm，对照者为0.64±0.16mm（p<0.01）。然而，两组的FA的IMT无显著差异（患者：0.80+0.30mm，对照者：0.75±0.31mm）。CCA的IMT与患者年龄相关（r=0.55；p<0.001），与总胆固醇水平相关（r=0.39；p<0.01），与高血压的存在相关（r=0.38；p<0.01）。每天吃水果的患者的FA的IMT明显低于不经常吃水果的患者（在CCA方面未发现此类差异）。线性多元回归分析表明这些变量是独立影响CAA和FA的IMD的因素。
在2型糖尿病患者诊断后的第一年就已显示出亚临床动脉粥样硬化增加。新诊断糖尿病患者中动脉粥样硬化发生的危险因素对CCA的影响大于FA。经常吃水果似乎对FA的动脉粥样硬化进展有有利影响。
