Goya K, Kitamura T, Inaba M, Otsuki M, Yamamoto H, Kurebayashi S, Sumitani S, Saito H, Kouhara H, Kasayama S, Kawase I
Department of Molecular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Metabolism. 2003 Oct;52(10):1302-6. doi: 10.1016/s0026-0495(03)00197-5.
Atherosclerotic vascular diseases are frequently associated with diabetes mellitus. There has been increasing evidence showing that the atherosclerotic diseases in diabetic patients are distinct from diabetic microvascular complications as to their pathophysiology and epidemiology. However, we have no information on the prevalence of asymptomatic atherosclerosis in diabetic patients before the onset of microvascular diseases. In the present investigation, we aimed to evaluate risk factors for the atherosclerosis in type 2 diabetic patients without the microvascular diseases. For this purpose, we evaluated atherosclerotic change of carotid arteries in 125 Japanese type 2 diabetic patients who had neither atherosclerotic vascular diseases nor diabetic microvascular complications. When atherosclerotic change was defined as the mean intima-media thickness (IMT) of >/= 1.1 mm and/or the presence of plaque lesion, 50% of patients had atherosclerosis of the carotid arteries. Risk factors for the carotid atherosclerosis were age, low-density lipoprotein (LDL)-cholesterol, hypertension, and diabetes treatment. Age and LDL-cholesterol were associated with mean IMT. Age, diabetes treatment, LDL-cholesterol, and hypertension were positively associated with plaque lesion, while high-density lipoprotein (HDL)-cholesterol was negatively associated with it. Fasting plasma glucose, glycosylated hemoglobin (HbA(1c)), and known diabetes duration remained unassociated with any parameters of asymptomatic atherosclerosis of the carotid arteries. These results indicate that glycemic control is unrelated with asymptomatic atherosclerosis in type 2 diabetic patients without diabetic microvascular complications. Conventional risk factors and diabetes treatment are independently associated with atherosclerosis of the carotid arteries in these patients.
动脉粥样硬化性血管疾病常与糖尿病相关。越来越多的证据表明，糖尿病患者的动脉粥样硬化疾病在病理生理学和流行病学方面与糖尿病微血管并发症不同。然而，在微血管疾病发作之前，我们没有关于糖尿病患者无症状动脉粥样硬化患病率的信息。在本研究中，我们旨在评估无微血管疾病的2型糖尿病患者动脉粥样硬化的危险因素。为此，我们评估了125例既无动脉粥样硬化性血管疾病也无糖尿病微血管并发症的日本2型糖尿病患者颈动脉的粥样硬化变化。当将粥样硬化变化定义为平均内膜中层厚度（IMT）≥1.1mm和/或存在斑块病变时，50%的患者存在颈动脉粥样硬化。颈动脉粥样硬化的危险因素为年龄、低密度脂蛋白（LDL）胆固醇、高血压和糖尿病治疗。年龄和LDL胆固醇与平均IMT相关。年龄、糖尿病治疗、LDL胆固醇和高血压与斑块病变呈正相关，而高密度脂蛋白（HDL）胆固醇与斑块病变呈负相关。空腹血糖、糖化血红蛋白（HbA1c）和已知糖尿病病程与颈动脉无症状动脉粥样硬化的任何参数均无关联。这些结果表明，血糖控制与无糖尿病微血管并发症的2型糖尿病患者的无症状动脉粥样硬化无关。传统危险因素和糖尿病治疗与这些患者的颈动脉粥样硬化独立相关。
