Güvener N, Tütüncü N B, Oto A, Erbås T
Department of Endocrinology, Hacettepe University Faculty of Medicine, Internal Medicine, Ankara, Turkey.
Endocr J. 2000 Oct;47(5):525-33. doi: 10.1507/endocrj.47.525.
The present study has been designed to quantify and compare right and left carotid intima-media thicknesses (IMT) in type 2 diabetics and healthy controls. It was also intended to investigate the effects of various risk factors on the carotid IMT in these subjects. A total of 122 subjects; 70 patients with type 2 diabetes and 52 non-diabetic subjects as controls, were recruited for the study. Right and left common carotid artery stiffness indices were assessed with ultrasonography in both groups. Age, body mass index (BMI), duration of diabetes, cigarette smoking, lipid profile including lipoprotein a, Chlamydia pneumonia seropositivity, glycemic indices, fasting insulin levels, serum fibrinogen levels and presence of hypertension, coronary artery disease, degenerative complications of diabetes mellitus were all assessed in order to define their role as determinants of carotid artery IMT. The difference between the groups regarding mean carotid IMT was statistically significant for the left carotid arteries (p = 0.028) and borderline significance was found for the right carotid arteries (p = 0.055). Age has a very strong association with carotid IMT in diabetic patients (p < 0.0001) with univariate analysis. According to the results of multivariate analysis, age and BMI were found to be the most important independent determinants of carotid IMT for both sides. When age was excluded from the model, BMI and coronary artery disease were found to have strong association with IMT on the right (p = 0.0036 and 0.0249) and BMI was the only significant determinant for the left side (p = 0.0025). This study shows that carotid IMT is greater in diabetic subjects compared with healthy controls. For the diabetic subjects, age, BMI and presence of coronary heart disease have a strong influence on the atherosclerotic process of the carotid arteries.
本研究旨在量化并比较2型糖尿病患者与健康对照者左右颈动脉内膜中层厚度（IMT）。同时，本研究还旨在探究各种风险因素对这些受试者颈动脉IMT的影响。本研究共招募了122名受试者，其中70例2型糖尿病患者和52例非糖尿病受试者作为对照。两组均采用超声检查评估左右颈总动脉僵硬度指数。对年龄、体重指数（BMI）、糖尿病病程、吸烟情况、血脂谱（包括脂蛋白a）、肺炎衣原体血清阳性率、血糖指数、空腹胰岛素水平、血清纤维蛋白原水平以及高血压、冠状动脉疾病、糖尿病退行性并发症的存在情况进行了评估，以确定它们作为颈动脉IMT决定因素的作用。两组之间平均颈动脉IMT的差异在左侧颈动脉具有统计学意义（p = 0.028），右侧颈动脉具有临界显著性（p = 0.055）。单因素分析显示，年龄与糖尿病患者的颈动脉IMT有非常强的相关性（p < 0.0001）。根据多因素分析结果，年龄和BMI被发现是两侧颈动脉IMT最重要的独立决定因素。当年龄被排除在模型之外时，BMI和冠状动脉疾病与右侧IMT有很强的相关性（p = 0.0036和0.0249），而BMI是左侧唯一显著的决定因素（p = 0.0025）。本研究表明，与健康对照者相比，糖尿病受试者的颈动脉IMT更大。对于糖尿病受试者，年龄、BMI和冠心病的存在对颈动脉的动脉粥样硬化进程有很大影响。
